Nocardiosis is a localized or disseminated infection caused by soil-borne aerobic actinomycetes. Pulmonary nocardiosis is a rare infection mostly occurring in immunocompromised patients.We reported a case of 36 year o...Nocardiosis is a localized or disseminated infection caused by soil-borne aerobic actinomycetes. Pulmonary nocardiosis is a rare infection mostly occurring in immunocompromised patients.We reported a case of 36 year old immunocompetent non-smoker female patient with no premorbid illness who presented with fever,cough with scanty sputum,hemoptysis,left sided chest pain and exertional dyspnea for two weeks.There was no past history of tuberculosis,diabetes mellitus or steroid therapy.Chest X-ray showed homogenous peripherally based opacity in the left upper zone.Bronchoscopy was done and brushing sent for culture,which showed colonies with features of Nocardia species after 48 hours.Further phenotypic characterization revealed it to be Nocardia otitidiscaviarum.Patient was treated with cotrimaxazole for six months after which complete recovery was evidenced symptomatically and radiologically.We report this case to emphasize the fact that among the Nocardia species,Nocardia otitidiscaviarum as causative agent of pulmonary disease is rarely reported even in immunocompromised individuals.展开更多
Rationale: Disseminated nocardiosis due to Nocardia otitidiscaviarum is rarely reported in immunocompetent hosts.Patient concerns: A 59 year old male patient complained of painful soft tissue swellings and fever for t...Rationale: Disseminated nocardiosis due to Nocardia otitidiscaviarum is rarely reported in immunocompetent hosts.Patient concerns: A 59 year old male patient complained of painful soft tissue swellings and fever for two days.Diagnosis: Disseminated nocardiosis due to Nocardia otitidiscaviarum. Interventions: Initial antimicrobial therapy with imipenem and trimethoprim/sulfamethoxazole was switched to 6 weeks of trimethoprim/sulfamethoxazole, linezolid and tigecycline after sensitivity test results were available. Thereafter, the patient was switched to maintenance trimethoprim/sulfamethoxazole and moxifloxacin. Prednisolone was gradually tapered.Outcomes: Soft tissue swelling and pain disappeared and the patient was discharged uneventfully.Lessons: Disseminated nocardiosis due to Nocardia otitidiscaviarum should be suspected in immunocompetent hosts with risk factors such as medication with prednisolone. Early identification of the causative species and susceptibility results is crucial given the diverse resistance patterns amongst various Nocardia species.展开更多
文摘Nocardiosis is a localized or disseminated infection caused by soil-borne aerobic actinomycetes. Pulmonary nocardiosis is a rare infection mostly occurring in immunocompromised patients.We reported a case of 36 year old immunocompetent non-smoker female patient with no premorbid illness who presented with fever,cough with scanty sputum,hemoptysis,left sided chest pain and exertional dyspnea for two weeks.There was no past history of tuberculosis,diabetes mellitus or steroid therapy.Chest X-ray showed homogenous peripherally based opacity in the left upper zone.Bronchoscopy was done and brushing sent for culture,which showed colonies with features of Nocardia species after 48 hours.Further phenotypic characterization revealed it to be Nocardia otitidiscaviarum.Patient was treated with cotrimaxazole for six months after which complete recovery was evidenced symptomatically and radiologically.We report this case to emphasize the fact that among the Nocardia species,Nocardia otitidiscaviarum as causative agent of pulmonary disease is rarely reported even in immunocompromised individuals.
文摘Rationale: Disseminated nocardiosis due to Nocardia otitidiscaviarum is rarely reported in immunocompetent hosts.Patient concerns: A 59 year old male patient complained of painful soft tissue swellings and fever for two days.Diagnosis: Disseminated nocardiosis due to Nocardia otitidiscaviarum. Interventions: Initial antimicrobial therapy with imipenem and trimethoprim/sulfamethoxazole was switched to 6 weeks of trimethoprim/sulfamethoxazole, linezolid and tigecycline after sensitivity test results were available. Thereafter, the patient was switched to maintenance trimethoprim/sulfamethoxazole and moxifloxacin. Prednisolone was gradually tapered.Outcomes: Soft tissue swelling and pain disappeared and the patient was discharged uneventfully.Lessons: Disseminated nocardiosis due to Nocardia otitidiscaviarum should be suspected in immunocompetent hosts with risk factors such as medication with prednisolone. Early identification of the causative species and susceptibility results is crucial given the diverse resistance patterns amongst various Nocardia species.
