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Doyle C, Costa Blasco M, MacEneaney O, Ryan C, Ní Raghallaigh S. Disseminated cutaneous nocardia. Int J Dermatol 2023; 62:e29-e31. [PMID: 35965351 DOI: 10.1111/ijd.16402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/30/2022] [Accepted: 08/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Claire Doyle
- Department of Dermatology, Beaumont Hospital, Dublin 9, Ireland
| | | | - Owen MacEneaney
- Department of Pathology, Beaumont Hospital, Dublin 9, Ireland
| | - Cliona Ryan
- Department of Pathology, Beaumont Hospital, Dublin 9, Ireland
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Essien F, Wolfley G, Tate J, Latack W, Carroll M. Nocardia asteroides occipital abscess as a cause of lupus nephritis? Clin Case Rep 2022; 10:e05265. [PMID: 35136605 PMCID: PMC8807664 DOI: 10.1002/ccr3.5265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/30/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology, which manifests in a multitude of manners. We present a case of lupus nephritis in a patient who developed complications of immunosuppressive treatment with eventual resolution of her nephritis following cure of her Nocardia brain abscess.
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Affiliation(s)
- Francis Essien
- Department of Internal MedicineDavid Grant Medical CenterTravis AFBCaliforniaUSA
| | - Graey Wolfley
- Department of Internal MedicineKeesler Medical CenterKeesler AFBMississippiUSA
| | - Joshua Tate
- Department of Internal MedicineDavid Grant Medical CenterTravis AFBCaliforniaUSA
- Division of EndocrinologyDepartment of Internal MedicineKeesler Medical CenterKeesler AFBMississippiUSA
| | - Wayne Latack
- Department of Internal MedicineDavid Grant Medical CenterTravis AFBCaliforniaUSA
- Division of NephrologyDepartment of Internal MedicineKeesler Medical CenterKeesler AFBMississippiUSA
| | - Matthew Carroll
- Department of RheumatologySinging River Health SystemOcean SpringsMississippiUSA
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Corsini Campioli C, Castillo Almeida NE, O'Horo JC, Challener D, Go JR, DeSimone DC, Sohail MR. Clinical Presentation, Management, and Outcomes of Patients With Brain Abscess due to Nocardia Species. Open Forum Infect Dis 2021; 8:ofab067. [PMID: 33855101 PMCID: PMC8026153 DOI: 10.1093/ofid/ofab067] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background Nocardial brain abscesses are rare, and published literature describing brain abscesses due to Nocardia species is limited to individual case reports or small series. We report one of the largest contemporary retrospective studies describing risk factors, diagnostic evaluation, management, and outcomes of nocardial brain abscess. Methods Retrospective review of all adults with brain abscess due to culture-confirmed Nocardia species at our institution between January 1, 2009, and June 30, 2020. Results Overall, 24 patients had nocardial brain abscesses during the study period. The median age at presentation was 64 years, and 62.5% were immunocompromised. Pulmonary and cutaneous infections were the most common primary sites of nocardial infection. All 24 patients had magnetic resonance imaging performed, and the frontal lobe was the most commonly involved. The most common organism isolated was Nocardia farcinica, followed by Nocardia wallacei and Nocardia cyriacigeorgica. Thirteen patients were managed with antimicrobial therapy alone, while 11 had both medical and surgical management. In all patients, dual therapy was recommended for the initial 6 weeks of treatment, and 22 patients received at least 1 oral agent as part of their final antibiotic regimen, predominantly trimethoprim-sulfamethoxazole and linezolid. Fourteen patients achieved complete clinical and radiographic resolution of infection. Conclusions Nocardia is an important cause of brain abscess in the immunocompromised host. Early diagnostic and therapeutic aspiration may help health care providers confirm the diagnosis, choose an appropriate antimicrobial regimen, and achieve source control.
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Affiliation(s)
| | | | - John C O'Horo
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, Minnesota, USA
| | - Douglas Challener
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - John Raymond Go
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel C DeSimone
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - M Rizwan Sohail
- Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
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Lesiones ectimatosas en el abdomen de un paciente con artritis reumatoide. Enferm Infecc Microbiol Clin 2015; 33:270-2. [DOI: 10.1016/j.eimc.2014.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/30/2014] [Accepted: 11/06/2014] [Indexed: 11/19/2022]
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Hu Y, Wang L, Huang X, Liang Y, Zhang J. Systemic Nocardia brasiliensis infection in a patient with systemic lupus erythematosus: successful diagnosis and therapy. Int J Dermatol 2014; 55:453-9. [PMID: 25311703 DOI: 10.1111/ijd.12712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 01/11/2014] [Accepted: 03/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Yongxuan Hu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Dermatology and Venereology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Li Wang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Dermatology and Venereology, The People's Hospital of Taiping, Dongguan, China
| | - Xiao Huang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuheng Liang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junmin Zhang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Cooper CJ, Said S, Popp M, Alkhateeb H, Rodriguez C, Aguilar MP, Alozie O. A complicated case of an immunocompetent patient with disseminated nocardiosis. Infect Dis Rep 2014; 6:5327. [PMID: 24757510 PMCID: PMC3987247 DOI: 10.4081/idr.2014.5327] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 02/17/2014] [Accepted: 02/25/2014] [Indexed: 12/21/2022] Open
Abstract
Nocardia species are aerobic, gram positive filamentous branching bacteria that have the potential to cause localized or disseminated infection. Nocardiosis is a rare disease that usually affects immunocompromised patients and presents as either pulmonary, cutaneous or disseminated nocardiosis. Forty-two year-old hispanic male presented to our care with bilateral lower extremity weakness, frontal headache, subjective fever, nausea, and vomiting. Brain computed tomography (CT) revealed multiple hyperdense lesions with vasogenic edema in the frontal, parietal and left temporal lobes. Chest CT demonstrated bilateral cavitary nodules in the lung and right hilar lymphadenopathy. Brain magnetic resonance imaging revealed multiple bilateral supratentorial and infratentorial rim enhancing lesions involving the subcortical gray-white matter interface with vasogenic edema. Patient was started on empiric therapy for unknown infectious etiology with no response. He eventually expired and autopsy findings revealed a right hilar lung abscess and multiple brain abscesses. Microscopic and culture findings from tissue sample during autopsy revealed nocardia wallacei species with multidrug resistance. The cause of death was stated as systemic nocadiosis (nocardia pneumonitis and encephalitis). The presence of simultaneous lung and brain abscesses is a reliable indication of an underlying Nocardia infection. An increased awareness of the various presentations of nocardiosis and a high index of clinical suspicion can help in a rapid diagnosis and improve survival in an otherwise fatal disease. This case highlights the importance of obtaining a tissue biopsy for definitive diagnosis on the initial presentation when an infectious process is considered in the differential diagnosis and early treatment can be initiated.
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Affiliation(s)
- Chad J. Cooper
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
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Hagiwara S, Tsuboi H, Hagiya C, Yokosawa M, Hirota T, Ebe H, Takahashi H, Ogishima H, Asashima H, Kondo Y, Umeda N, Suzuki T, Hitomi S, Matsumoto I, Sumida T. Pulmonary nocardiosis in patients with connective tissue disease: A report of two cases. Intractable Rare Dis Res 2014; 3:25-8. [PMID: 25343123 PMCID: PMC4204540 DOI: 10.5582/irdr.3.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 02/06/2014] [Indexed: 11/05/2022] Open
Abstract
Reported here are 2 patients with connective tissue disease who developed pulmonary nocardiosis. Case 1 involved a 73-year-old man with malignant rheumatoid arthritis treated with prednisolone 25 mg/day. Chest X-rays revealed a pulmonary cavity and bronchoscopy detected Nocardia species. The patient was successfully treated with trimethoprim/sulfamethoxazole. Case 2 involved a 41-year-old woman with systemic lupus erythematosus. The patient received remission induction therapy with 50 mg/day of prednisolone and tacrolimus. Six weeks later, a chest CT scan revealed a pulmonary cavity; bronchoscopy resulted in a diagnosis of pulmonary nocardiosis. The patient had difficulty tolerating trimethoprim/sulfamethoxazole, so she was switched to and successfully treated with imipenem/cilastatin and amikacin.
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Affiliation(s)
- Shinya Hagiwara
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroto Tsuboi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chihiro Hagiya
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Yokosawa
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoya Hirota
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Ebe
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroyuki Takahashi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Ogishima
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiromitsu Asashima
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuya Kondo
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naoto Umeda
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeshi Suzuki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shigemi Hitomi
- Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Isao Matsumoto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Address correspondence to: Dr. Takayuki Sumida, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. E-mail:
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Caza T, Oaks Z, Perl A. Interplay of Infections, Autoimmunity, and Immunosuppression in Systemic Lupus Erythematosus. Int Rev Immunol 2014; 33:330-63. [DOI: 10.3109/08830185.2013.863305] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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