Pulmonary nocardiosis caused by Nocardia otitidiscaviarum in an adult asthmatic female patient: The presence of acid-fast branching filaments is always significant

Abstract

We report a case of pulmonary nocardiosis in a 41-year-old asthma patient. Chest radiographs showed bilateral air space and consolidations. Acid-fast branching filaments were demonstrated in sputum, and the grown organism was identified phenotypically and confirmed using 16S rDNA sequencing (accession no. KX500116). The patient received a combination of medical treatments, but developed complications, which were managed over the next 3 months, after which she was discharged. Pulmonary nocardiosis should be considered in patients undergoing steroid therapy or when a chronic infection does not respond to first-line treatment.

A fatal case of disseminated nocardiosis due to Nocardia otitidiscaviarum resistant to trimethoprim–sulfamethoxazole: case report and literature review

“…In our case, the isolated N. otitidiscaviarum was susceptible to Linezolid and Amikacin and was resistant to TMP-SMX, Ciprofloxacin, Imipenem, Cefepime, Cefoxitin, Amoxicillin-Clavulanic acid, Clarithromycin and Tobramycin. Seven cases were similarly reported with resistance to TMP-SMX [ 17 , 19 , 21 , 24 , 28 , 30 ] with four cases reported in immunocompetent patients [ 17 , 19 , 24 ], and one infecting a farmer [ 19 ], details of these studies are described in Table 4…”

“…Susceptible to: Amikacin, Minocycline, Clarithromycin TMP-SMX à Clarithromycin + Amikacin Recovered Yoshida et al [ 30 ] 2004 69M On Corticosteroid therapy Resistant to: Ampicillin, Piperacillin, Cefazolin, Imipenem, minocycline, Vancomycin, TMP-SMX, Erythromycin. Susceptible to: Levofloxacin, Gentamicin and Levofloxacin Imipenem + TMP-SMX à TMP-SMX + Gentamicin Recovered Mahgoub et al [ 17 ] 2016 41F Immunocompetent Resistant to: Azithromycin, Ceftazidime, Penicillin, Rifampicin and TMP-SMX. Susceptible to: Amikacin, Ciprofloxacin, Meropenem and Streptomycin TMP-SMX + Amikacin + Imipenem à Ceftriaxone + Amikacin + Ciprofloxacin Recovered Candel et al [ 13 ] 2017 79M On Corticosteroid therapy Resistant to: TMP-SMX.…”

Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review

“…The Pubmed and Google scholar database was searched with 'Nocardia otitidiscaviarum', 'lung infection', 'pulmonary' and 'pneumonia' and 23 cases have been reported [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37], which are presented in Table 3. Sixteen cases were male and seven were female patients.…”

“…The median age at the time of presentation was 58 years (range 14-85 years). Nine of the twenty-three reported cases had associated chronic pulmonary diseases including bronchial asthma, chronic obstructive pulmonary disease (COPD), tuberculosis at the time of infection [19,20,23,25,29,30,31,37]. Thirteen of these twenty-three cases were reported in immunocompromised patients.…”