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Nocardia
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
TMP-SMX 960 mg thrice weekly or 480 mg once daily is used in allogeneic stem cell transplant recipients and immunocompromised individuals receiving high-dose steroids for ≥4 weeks to prevent Pneumocystis jirovecii infection, and reactivation of toxoplasma in HSCT recipients. This regimen coincidentally also prevents nocardiosis; however, breakthrough infection has been reported. Interestingly, these Nocardia isolates may still be susceptible to TMP-SMX.
Infections in Solid Organ Transplant Recipients Admitted to the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Almudena Burillo, Patricia Muñoz, Emilio Bouza
Nocardiosis is usually observed between 1 and 6 months post-transplantation. Risk factors are high calcineurin inhibitor trough levels in the month before diagnosis (OR, 6.11), use of tacrolimus (OR, 2.65) and corticosteroid dose (OR, 1.12) at the time of diagnosis, patient age (OR, 1.04), and length of CCU stay after SOT (OR, 1.04) [140]. The clinical presentation of nocardiosis includes pneumonia, focal CNS lesions, and skin involvement [116,141–145]. Brain abscesses due to Nocardia spp. are multiple in 40% of cases and may show ring enhancement.
Nocardiosis *
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
Nocardiosis is usually not considered in the differential diagnosis of interstitial pneumonitis. However, a few cases have been encountered with chest radiographs revealing diffuse bilateral interstitial and alveolar disease.1 For this reason a brief description of nocardiosis is provided.
Successful treatment with amoxicillin-clavulanic acid: cutaneous nocardiosis caused by Nocardia brasiliensis
Published in Journal of Dermatological Treatment, 2023
Youqi Ji, Fang Su, Xin Hong, Mengyuan Chen, Yongze Zhu, Dongqing Cheng, Yumei Ge
Trimethoprim-sulfamethoxazole is the first-line antibacterial agent for years in initial therapy of nocardiosis, occasionally combines with amikacin, third-generation cephalosporins, linezolid or imipenem (1,2). However, sulfonamide-resistant or linezolid-resistant Nocardia strains have been isolated in clinical in recent years, which brings great challenges to the clinical treatment of Nocardia (3,4). In addition, Sulfonamides are of great toxicity and side effects (5–8), mainly including: (1) anaphylaxis, accompanied by skin itching, rash, dermatitis or angioneurotic edema; (2) jaundice, abnormal liver function, acute liver necrosis;(3) crystal deposition in the urine, causing hematuria and renal calculus; (4) granulopenia, thrombocytopenia, aplastic anemia; (5) sulfonamides enter the fetal circulation through the placenta and affect infant development. Therefore, non-sulfonamides treatment of nocardiosis should be emphasized. Here, we reported a case of cutaneous nocardiosis caused by Nocardia brasiliensis infection in an immunocompetent individual who was successfully treated with amoxicillin-clavulanic acid.
Infective endocarditis by Nocardia species: a systematic review
Published in Journal of Chemotherapy, 2023
Antonios Velidakis, Fotios Degaitis, George Tsorbatzoglou, Petros Ioannou
IE is an infrequent disease that carries a significant mortality and morbidity rate. IE is usually caused by Gram-positive bacteria such as Enterococcus, Staphylococcus and Streptococcus, however, it may be caused by Gram-negative bacteria in some cases, such as in cases of previous exposure to the healthcare system [40,41]. On the other hand, nocardiosis is a relatively rare disease that can be life-threatening in the case of disseminated disease that mostly involves immunocompromised individuals. IE by Nocardia is a very rare disease with most reports up to now being from case reports. To the best of our knowledge, this is the first study that tries to systematically review IE by Nocardia spp. and provide data on its epidemiology, microbiology, clinical characteristics, treatment and outcomes.
Brain metastasis or nocardiosis? A case report of central nervous system Nocardiosis with a review of the literature
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Hojin Sun, Mariam Goolam Mahomed, Jaimin Patel
Nocardiosis is a rare infection caused by aerobic, gram-positive, weakly acid-fast, branching, rod-shaped bacterium of the Nocardia genus [1]. These bacteria are widely found in soil, and human infections occur by inhalation or direct inoculation of the skin [2]. Nocardiosis is typically regarded as an opportunistic infection with cell-mediated immunodeficiency being a risk factor; however, up to one-third of infected patients are immunocompetent. The presentation of nocardiosis varies, but pulmonary nocardiosis is the most common presentation in up to two-thirds of cases with cutaneous nocardiosis as the presentation in most other cases. Nocardia can involve the central nervous system (CNS) in 44% of cases; an isolated CNS presentation is found in as few as 9% of cases [3]. In CNS nocardiosis, the disease can be clinically silent, and if symptoms do arise, they may be thought to be due to mass lesions rather than infection [2]. Thus, CNS nocardiosis may be misdiagnosed as a neoplasm initially, especially given the rarity of nocardiosis. We present a case of isolated CNS nocardiosis with bacteremia in an immunocompromised patient who presented with dizziness and blurry vision.