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Jin L, Zhang W, Su F, Ji Y, Ge Y. Brain abscesses: the first report of disseminated Nocardia beijingensis infection in an immunocompetent individual in China. BMC Neurol 2024; 24:341. [PMID: 39272012 PMCID: PMC11396844 DOI: 10.1186/s12883-024-03826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024] Open
Abstract
Nocardia is widely distributed in the natural environment and typically cause opportunistic infections. However, it is important to note that the pathogenicity of different Nocardia species may vary significantly. Here we reported the first case of brain abscess caused by Nocardia beijingensis (N. beijingensis) infection in China. A 70-year-old male immunocompetent individual came to our hospital for treatment due to headache. After examination, it was found that he had a brain abscess caused by N. beijingensis. By utilizing a combination of surgical intervention and antibiotic therapy, the patient ultimately achieved full recovery. In addition, we isolated this strain and displayed its ultrastructure through scanning electron microscopy. The phylogenetic tree was analyzed by 16 S rRNA sequence. A literature review of N. beijingensis infections in all immunocompetent and immunocompromised patients was presented. It highlighted that abscess formation appears to be a common manifestation of N. beijingensis infection, and N. beijingensis has become an emerging pathogen in immunocompetent individuals.
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Affiliation(s)
- Lihong Jin
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
- Department of Clinical Laboratory, The First People's Hosiptal of Lin'an District, Hangzhou, Zhejiang, 311399, China
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Weiqun Zhang
- Department of Clinical Laboratory, The First People's Hosiptal of Lin'an District, Hangzhou, Zhejiang, 311399, China
| | - Fang Su
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Youqi Ji
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Yumei Ge
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China.
- Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang Province, Hangzhou, Zhejiang, 310053, China.
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Qi L, Fan W, Li J, Cui H, Xu J, Gu D, Meng J, Liu J. Persistent Nocardia beijingensis infection in a patient with postoperative abscess and misuse of antibiotics in China. INFECTIOUS MEDICINE 2023; 2:343-348. [PMID: 38205174 PMCID: PMC10774666 DOI: 10.1016/j.imj.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/25/2023] [Accepted: 11/07/2023] [Indexed: 01/12/2024]
Abstract
Here we describe the first case of abscess infection caused by Nocardia beijingensis in China. The patient was immunocompetent but suffered from postoperative abscess for 6 years. This study highlights the necessity of long-term infected foci to be thoroughly examined to identify the pathogen, as well as the importance of accurate Nocardia identification and antimicrobial susceptibility tests for understanding the pathogen's epidemiology, clinical significance, and treatment strategy.
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Affiliation(s)
- Lihua Qi
- Department of Clinical Laboratory, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Weihong Fan
- Department of Clinical Laboratory, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Jing Li
- Department of Pathology, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Hongfei Cui
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Jianxia Xu
- Department of Clinical Laboratory, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Dongmei Gu
- Department of Clinical Laboratory, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Jiaojiao Meng
- Department of Medical Imaging, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
| | - Jie Liu
- Department of Clinical Laboratory, Seventh Medical Center, PLA General Hospital, Beijing 100700, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 518055, China
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Diioia A, Kalra L, Krop LC. Stroke like presentation of disseminated CNS Nocardia beijingensis infection in an immunocompetent patient: Case report and review of the literature. IDCases 2021; 25:e01223. [PMID: 34307047 PMCID: PMC8287212 DOI: 10.1016/j.idcr.2021.e01223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 10/25/2022] Open
Abstract
We describe a rare case of pulmonary and central nervous system (CNS) Nocardia beijingensis infection in an immunocompetent patient presenting with stroke like symptoms and newly discovered pulmonary and brain mass. Initial work up suggested lung cancer with metastasis to the brain. However, further evaluation revealed disseminated N. beijingensis. A literature review of N. beijingensis infections in immunocompetent host is also presented.
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Affiliation(s)
- Alessandra Diioia
- Morton Plant Hospital, BayCare Health System, Clearwater, FL, USA.,University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Lalit Kalra
- Morton Plant Hospital, BayCare Health System, Clearwater, FL, USA.,Morton Plant Mease Health Care, Consultants in Infectious Diseases, Inc., Clearwater, FL, USA
| | - Lynne C Krop
- Morton Plant Hospital, BayCare Health System, Clearwater, FL, USA
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Roy M, Martial A, Ahmad S. Disseminated Nocardia beijingensis Infection in an Immunocompetent Patient. Eur J Case Rep Intern Med 2020; 7:001904. [PMID: 33194869 DOI: 10.12890/2020_001904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 11/05/2022] Open
Abstract
Nocardia is a genus of aerobic, non-motile and non-spore-forming filamentous branching bacteria with fragmentation into bacillary or coccoid forms. Infections caused by Nocardia often occur in immunocompromised hosts and are potentially life-threatening. Nocardia beijingensis has rarely been reported to cause infection in immunocompetent hosts. We present a case of disseminated infection due to Nocardia beijingensis in a patient with no known medical comorbidities, who presented with new-onset seizure. Another interesting finding in our case is that our patient did not have any pulmonary symptoms despite chest CT showing the pulmonary system as the likely primary site of infection. As per our literature review, this is the seventh reported case of infection due to Nocardia beijingensis in an immunocompetent host. LEARNING POINTS To recognize Nocardia beijingensis, a slow-growing weakly acid-fast filamentous bacteria commonly causing opportunistic infections in immunocompromised hosts, as an emerging pathogen in immunocompetent patients.Tissue biopsy with Gram staining showing variable filamentous bacteria and confirmation of species using restriction enzyme analysis and 16S rRNA analysis is needed to establish a diagnosis of infection.Trimethoprim/sulfamethoxazole has been successfully used to treat infection due to Nocardia beijingensis.
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Affiliation(s)
- Moni Roy
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA and OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Annia Martial
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Sharjeel Ahmad
- Section of Infectious Diseases, Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
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Menace Elbow: Disseminated Nocardiosis. Am J Med 2018; 131:1307-1309. [PMID: 29729234 PMCID: PMC6482376 DOI: 10.1016/j.amjmed.2018.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/26/2022]
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Keenan JG, Mohapatra S. Nocardia beijingensis brain abscesses in an HIV-infected individual. IDCases 2017; 9:65-69. [PMID: 28706854 PMCID: PMC5499028 DOI: 10.1016/j.idcr.2017.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/12/2017] [Accepted: 03/13/2017] [Indexed: 11/15/2022] Open
Abstract
We describe a case of a 50-year-old Hispanic man diagnosed with HIV/AIDS who presented with a generalized tonic clonic seizure and ring enhancing cerebral lesions on imaging. He was initially treated for CNS toxoplasmosis but presented to the hospital with another tonic clonic seizure despite prescribed therapy. Brain biopsy was performed which revealed Nocardia beijingensis. He was treated with intravenous meropenem and trimethoprim/sulfamethoxazole for six weeks followed by long term oral trimethoprim/sulfamethoxazole with radiographic and clinical improvement.
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Affiliation(s)
- Jolie Guevara Keenan
- Mount Sinai Hospital, 1500 South Fairfield Avenue, Chicago, Illinois 60608, United States
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Erratum to "Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient". Case Rep Pulmonol 2016; 2016:1950463. [PMID: 27493823 PMCID: PMC4967460 DOI: 10.1155/2016/1950463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022] Open
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