Nocardiosis Associated with Primary Immunodeficiencies (Nocar-DIP): an International Retrospective Study and Literature Review

Lafont, Emmanuel; Marciano, Beatriz E.; Mahlaoui, Nizar; Neven, Bénédicte; Bustamante, Jacinta; Rodríguez-Nava, Verónica; Rawat, Amit; Unzaga, M.J.; Fischer, Alain; Blanche, Stéphane; Lortholary, Olivier; Holland, Steven M.; Lebeaux, David

doi:10.1007/s10875-020-00866-8

Cited by 13 publications

(19 citation statements)

References 47 publications

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“…A retrospective study showed that among these cases of PID complicated by invasive nocardiosis, chronic granulomatous disease (CGD) was most common (43/49, 83.8%). 17 Even in this subpopulation, the incidence of nocardiosis was low, ranging from 0.0044 to 0.0057 cases/patient year. 17 Non-CGD PID (such as IL12RB1 deficiency or idiopathic CD4 lymphopenia) was rare, but often revealed by development of nocardiosis.…”

Section: Disease Presentationmentioning

confidence: 83%

“…17 Even in this subpopulation, the incidence of nocardiosis was low, ranging from 0.0044 to 0.0057 cases/patient year. 17 Non-CGD PID (such as IL12RB1 deficiency or idiopathic CD4 lymphopenia) was rare, but often revealed by development of nocardiosis. More recently, anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies, which reduce neutrophil and macrophage activation, phagocytosis, and bactericidal activity through the inhibition of GM-CSFinduced STAT5 phosphorylation, were identified in five out of seven patients with unexplained disseminated nocardiosis.…”

Section: Disease Presentationmentioning

confidence: 83%

“…14,15 Lung biopsy may be required if BAL examination is negative, especially if there is a nodular lesion. 17 If brain nocardiosis is suspected, obtaining a positive microbiological result using BAL or skin biopsy may prevent the need to perform an invasive procedure. If no diagnosis is reached despite the above-mentioned workup, stereotactic needle biopsy or craniotomy drainage should be performed if there is a brain abscess.…”

Section: Dovepressmentioning

confidence: 99%

“…Because low-dose cotrimoxazole does not prevent nocardiosis among solid organ transplant recipients, higher doses should be used for secondary prophylaxis, as shown in patients with CGD (eg, 160/800 mg of TMP-SMX daily). 7,14,15,17…”

Section: Treatmentmentioning

confidence: 99%

“…64 Fungal co-infections were also demonstrated among 3/45 (6.7%) patients with primary immunodeficiency. 17 Finally, if none of the abovementioned reasons is identified, a paradoxical reaction should be considered. However, this event seems to be extremely rare: a single case-report has been published to date, of a paradoxical response in cerebral nocardiosis occurring in a renal transplant recipient.…”

Section: Follow-up and Prognosismentioning

confidence: 99%

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Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment – Old Questions, New Answers?

Lafont¹,

Conan²,

Rodríguez-Nava³

et al. 2020

IDR

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Nocardia spp. is an environmental filamentous Gram-positive bacterium that may cause infections in humans and, despite recent progress, many challenges remain regarding the management of nocardiosis. This review aims at describing most recently published data regarding the diagnosis, treatment and follow-up of patients with invasive nocardiosis. As nocardiosis mainly affects patients with cell-mediated immunity defects, a comprehensive workup is mandatory in case of invasive nocardiosis occurring in ”apparently healthy patients”. Indeed, invasive nocardiosis might reveal an unknown primary immunodeficiency or the presence of anti-GM-CSF autoantibodies. Even if the diagnosis of nocardiosis mostly relies on direct examination and bacterial culture, a genus-specific PCR may be used for the detection of Nocardia , when directly performed on a clinical sample. Brain imaging should always be performed, even in the absence of neurological symptoms. Cotrimoxazole (trimethoprim/sulfamethoxazole), linezolid, parenteral cephalosporins, carbapenems and amikacin may be used as initial antibiotics to treat nocardiosis. Cotrimoxazole or linezolid can be used as monotherapy in selected patients without brain involvement. Although treatment duration has historically been set to at least 6 months in the absence of central nervous system involvement, shorter durations (<120 days) seem to be associated with a favourable outcome.

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Section: Disease Presentationmentioning

confidence: 83%

Section: Disease Presentationmentioning

confidence: 83%

Section: Dovepressmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Follow-up and Prognosismentioning

confidence: 99%

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Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment – Old Questions, New Answers?

Lafont¹,

Conan²,

Rodríguez-Nava³

et al. 2020

IDR

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A rare case of pulmonary nocardiosis comorbid with Sjogren’s syndrome

Peng

Dong

Zhu

et al. 2021

Clinical Laboratory Analysis

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Nocardia is Gram-positive, weakly acid-fast, catalase-positive, nonmotile, branching rod-shaped aerobic bacteria, belonging to actinomycetales. 1,2 Nocardia widely exists in soil, water, air, and rotten plants. It is common in patients with T-cell deficiency (leukemia or AIDS), long-term usage of immunosuppressants (such as organ transplantation and malignant tumor), or patients with underlying diseases (such as diabetes and chronic kidney disease). [3][4][5][6] Pulmonary nocardiosis is a purulent and granulomatous disease caused by Nocardia invading the lung through respiratory tract inhalation or skin lesions. It can spread into the brain, kidney, and other organs by blood dissemination and even form life-threatening sepsis.The clinical manifestations of pulmonary nocardiosis are fever, cough, expectoration, dyspnea, chest pain, hemoptysis, weight loss, fatigue, and other symptoms. Pulmonary nocardiosis is commonly characterized by infiltrative lesions, cavities, nodules, or masses in lung segments or lobes in computed tomography. Because its clinical manifestations and imaging are not specific to common bacterial infection, pulmonary aspergillosis, lung cancer, pulmonary abscess,

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Chronic Granulomatous Disease

Stasia

Roos

2023

NADPH Oxidases Revisited: From Function to Structure

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Nocardiosis Associated with Primary Immunodeficiencies (Nocar-DIP): an International Retrospective Study and Literature Review

Cited by 13 publications

References 47 publications

Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment – Old Questions, New Answers?

Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment – Old Questions, New Answers?

A rare case of pulmonary nocardiosis comorbid with Sjogren’s syndrome

Chronic Granulomatous Disease

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