Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review

Wang, Tao; Yun, Jia; Chu, Bao; Liu, Hongtao; Dong, Xiao; Zhang, Yan

doi:10.7150/ijms.32440

Cited by 17 publications

(23 citation statements)

References 44 publications

(51 reference statements)

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“…Nephrologists should be extremely vigilant for C. auris infection. The reasons for the association of kidney disease with mortality may include the frequent use of immunosuppressants in the treatment process of patients with kidney disease; ( Wang et al, 2019 ) the fact that most patients with kidney disease have low protein and malnutrition, which leads to a decline in immunity ( Rhee et al, 2018 ); the fact that patients with kidney disease often suffer from diabetes ( Alicic et al, 2017 ); and the dialysis treatments required by many patients with kidney disease ( Collister et al, 2017 ). As the high infection rate in kidney disease patients is specific to C. auris compared with other Candida species, nephrologists in many regions do not have a high awareness of C. auris infections.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

Zhu

Jiang

et al. 2021

Front. Microbiol.

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IntroductionCandida auris is an emerging multidrug-resistant fungus that may cause infections with a high mortality rate. The first case of C. auris infection was reported in 2009 and infections have been reported in 44 countries. The fungus now represents a major global public health threat. We analyzed cases from the emergence of C. auris infections up until the end of 2020. It is hoped that the results of this analysis will raise awareness in scientists to promote protection and control research pertaining to this pathogen.MethodsPubMed and Web of Science databases were searched for all papers related to C. auris infections up until December 31, 2020. We sorted and organized these data into the following categories: date of publication, patient age and sex, underlying diseases, risk factors for infection, patient mortality information, drug sensitivity information of C. auris isolates, and genetic classification. The χ2 test was used to screen for factors that may affect patient mortality.ResultsA total of 912 patients were included in the analysis. There’s a higher proportion of men and a high proportion of patients were premature babies and elderly people. The proportions of patients with underlying diseases such as diabetes, kidney disease, trauma, and ear disease were also high. More than half of patients had a history of central venous catheter use and a history of broad-spectrum antibiotic use. The χ2 test revealed that only kidney disease (P < 0.05) was an important risk factor for mortality in C. auris-infected patients.ConclusionsA comprehensive understanding of C. auris was achieved following this retrospective analysis, including the characteristics of C. auris-infected patients. In recent years, increasing numbers of multidrug-resistant C. auris isolates have been identified, and the high mortality rates associated with infection merit greater attention from the medical world.

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Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

Zhu

Jiang

et al. 2021

Front. Microbiol.

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“…Eleven sporadic glomerular disease cases with nocardiosis have ever been reported in the literature. All these eleven patients accepted immunosuppressive agents for kidney disease; pulmonary infection was the most common; 45% of patients accepted trimethoprim-sulfamethoxazole treatment; and only two patients died [31][32][33][34]. Here, we comprehensively reviewed the manifestations of and treatments for nocardiosis in 7 glomerular disease patients who received glucocorticoids alone or combined with immunosuppressive agents.…”

Section: Discussionmentioning

confidence: 99%

“…Serious cases of nocardiosis can lead to disseminated infections and even the emergence of brain abscesses [26][27][28][29]. Unfortunately, nocardiosis is quite complex and rare, and it is difficult to differentiate it from other fever-related diseases, lung cancers and metastatic tumors [29][30][31]. Misdiagnosis and delayed treatment of nocardiosis are common in glomerular disease patients, which has brought a challenge for the comprehensive understanding of nocardiosis.…”

Section: Introductionmentioning

confidence: 99%

Nocardiosis in glomerular disease patients with immunosuppressive therapy

et al. 2020

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Background Glomerular disease patients have a high risk of infection, which contributes to the progression of disease per se and mortality, especially in those with long-term use of glucocorticoids and (or) immunosuppressive agents. Cases of sporadic nocardiosis have been reported in glomerular disease patients, and this observation was conducted to comprehensively understand the manifestations of and treatments for nocardiosis, which is commonly misdiagnosed as pneumonia or tuberculosis or even as lung cancer or metastatic tumors in glomerular disease patients. Methods We reviewed the demographic characteristics, laboratory abnormalities, radiological features, and treatments of 7 patients with nocardiosis and glomerular disease receiving steroids and immunosuppression therapy at the nephrology department of the Second Xiangya Hospital between 2012 and 2019. Results It was found that all 7 patients had been receiving methylprednisolone for renal disease at a median dose of 20 mg per day and a median duration of 4 months before developing nocardiosis. There were 4 males and 3 females, and the median age was 52.14 years. All 7 patients had hypoalbuminemia at the time of admission. In addition, various cystic abscesses in the subcutaneous tissue, with or without lung and brain involvement, were observed in these patients. Encouragingly, body temperatures returned to normal, and subcutaneous abscesses diminished or disappeared with compound sulfamethoxazole treatment alone or in combination with linezolid, imipenem and mezlocillin/sulbactam. Conclusions It was shown that multisite abscesses, including subcutaneous, pulmonary and cerebral abscesses, were the common manifestations of nocardiosis in glomerular disease patients. Sulfonamide was the first-line antibiotic therapy for nocardiosis, and combinations of other antibiotics were also needed in some serious cases.

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“…Indeed, the leading cause of death in patients with systemic lupus erythematosus (SLE) was treatment-associated infection (33%), exceeding that caused by the disease itself (31%) [3]. Likewise, we had in the kidney diseases patients under immunosuppressive therapy encountered tuberculosis flare-up, cryptococcal infection, Pneumocystis pneumonia and, in the hard way, lethal nocardiosis [4]. Facing these grim situations, we have designed a risk score to predict pulmonary infection in patients with primary…”

Section: Introductionmentioning

confidence: 99%

From Severe Herpes Zoster to Rare Suid Herpesvirus Encephalitis: A New Twist of the Varicellovirus Genus Infection in Patients with Kidney Diseases

Zhang

Dong

et al. 2020

Int. J. Med. Sci.

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Both the herpes zoster virus and suid herpesvirus type 1 (SuHV-1) belong to the Varicellovirus genus of the α-herpesviridae subfamily. They may cause opportunistic infections especially in patients with kidney diseases, varying from latent illness to overt lethality. Under these circumstances, impaired renal function is both the culprit for and victim of the infection. However, fulminant eruption of severe skin herpes zoster in lupus nephritis (LN) patients under prolonged immunosuppressive therapy is rare and even more rarely seen is the SuHV-1 encephalitis in human. Facing the evolution of these rare infections, we hence chose to review the clinical pathogenicity of these two viruses which were cognate in origin but distinct in virulence. As such, we began with the first of the two above viral diseases and proceeded with peculiar renal involvement, unique clinical symptoms and pertinent lethal risk. Of importance, LN was used to exemplify the reciprocally detrimental interactions between impaired renal function and suppressed immune response. Then in a manner similar to the gradient overlay, SuHV-1 encephalitis was discussed focusing on its neurotropic features, specific MRI findings and exclusive test of high throughput sequencing. Our report highlighted novel presentations of the Varicellovirus genus infection by providing a productive multidisciplinary communication with pointed disclosure of the renal involvement. It may therefore be of great medical relevance and educational value for clinicians, especially the unseasoned ones, to foresee and manage similar cases in susceptible patients.

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Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review

Cited by 17 publications

References 44 publications

Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

Nocardiosis in glomerular disease patients with immunosuppressive therapy

From Severe Herpes Zoster to Rare Suid Herpesvirus Encephalitis: A New Twist of the Varicellovirus Genus Infection in Patients with Kidney Diseases

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