Specific clinical manifestations of Nocardia: A case report and literature review

Yu,Songsong; Wang,Jing; Fang,Qiuhong; Zhang,Jixin; Yan,Fengcai

doi:10.3892/etm.2016.3571

Specific clinical manifestations of Nocardia: A case report and literature review

Authors:
- Songsong Yu
- Jing Wang
- Qiuhong Fang
- Jixin Zhang
- Fengcai Yan
View Affiliations

Affiliations: Emergency Department, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing 100038, P.R. China, Pulmonary and Critical Care Department, Beijing Chaoyang Hospital, Capital Medical University, Shijingshan, Beijing 100043, P.R. China, Pathology Department, Peking University First Hospital, Xicheng, Beijing 100034, P.R. China, Pathology Department, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing 100038, P.R. China
Published online on: August 4, 2016 https://doi.org/10.3892/etm.2016.3571
Pages: 2021-2026
Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Nocardiosis is a rare bacterial infection of either the lungs (pulmonary) or body (systemic) that usually affects immunocompromised individuals. It is caused by Gram‑positive, aerobic actinomycetes of the Nocardia genus. Multiple high‑density sheet shadows in both lungs along with nodules or cavities are the most common presentations of nocardiosis, whereas a large pulmonary mass is considered to be rare. However, there is no specificity in the clinical manifestation of the disease. Therefore, isolation and identification of Nocardia strains is the only reliable diagnostic method. The present study describes the cases of two male patients of Asian descent with nocardiosis. Chest computed tomography scans showed a suspected tumor mass in both patients. Microscopic analysis and culturing of tissue samples obtained using a bronchoscope detected the presence of Nocardia wallacei. Neither patient showed signs of immunosuppression. The present study aimed to improve the understanding of lung nocardiosis and demonstrated that pulmonary nocardiosis should be suspected in the case of non‑immunocompromised patients with a large mass in the lung. Furthermore, a review of the literature on infection with Nocardia was conducted.

View Figures

View References

1	BrownElliott BA, Brown JM, Conville PS and Wallace RJ Jr: Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 19:259–282. 2006. View Article : Google Scholar : PubMed/NCBI
2	King AS, Castro JG and Dow GC: Nocardia farcinica lung abscess presenting in the context of advanced HIV infection: Spontaneous resolution in response to highly active antiretroviral therapy alone. Can J Infect Dis Med Microbiol. 20:e103–e106. 2009.PubMed/NCBI
3	Tuo MH, Tsai YH, Tseng HK, Wang WS, Liu CP and Lee CM: Clinical experiences of pulmonary and bloodstream nocardiosis in two tertiary care hospitals in northern Taiwan, 2000-2004. J Microbiol Immunol Infect. 41:130–136. 2008.PubMed/NCBI
4	Abreu C, RochaPereira N, Sarmento A and Magro F: Nocardia infections among immunomodulated inflammatory bowel disease patients: A review. World J Gastroenterol. 21:6491–6498. 2015. View Article : Google Scholar : PubMed/NCBI
5	Wu BQ, Zhang TT, Zhu JX, Liu H, Huang J and Zhang WX: Pulmonary nocardiosis in immunocompromised host: Report of 2 cases and review of the literature. Zhonghua Jie He He Hu Xi Za Zhi. 32:593–597. 2009.(In Chinese). PubMed/NCBI
6	Mari B, Montón C, Mariscal D, Luján M, Sala M and Domingo C: Pulmonary nocardiosis: Clinical experience in ten cases. Respiration. 68:382–388. 2001. View Article : Google Scholar : PubMed/NCBI
7	Márquez-Diaz F, Soto-Ramirez LE and Sifuentes-Osornio J: Nocardiasis in patients with HIV infection. AIDS Patient Care STDS. 12:825–832. 1998. View Article : Google Scholar : PubMed/NCBI
8	Li HE and Wang Yan: Analysis of Nocardia infections 16 cases. Yi Yao Lun Tan Za Zhi. 16:71–73. 2011.(In Chinese).
9	Kageyama A, Yazawa K, Ishikawa J, Hotta K, Nishimura K and Mikami Y: Nocardial infections in Japan from 1992 to 2001, including the first report of infection by Nocardia transvalensis. Eur J Epidemiol. 19:383–389. 2004. View Article : Google Scholar : PubMed/NCBI
10	Holtz HA, Lavery DP and Kapila R: Actinomycetales infection in the acquired immunodeficiency syndrome. Ann Intern Med. 102:203–205. 1985. View Article : Google Scholar : PubMed/NCBI
11	Farina C, Boiron P, Goglio A and Provost F: Human nocardiosis in northern Italy from 1982 to 1992. Northern Italy Collaborative Group on Nocardiosis. Scand J Infect Dis. 27:23–27. 1995. View Article : Google Scholar : PubMed/NCBI
12	Geiseler PJ and Andersen BR: Results of therapy in systemic nocardiosis. Am J Med Sci. 278:188–194. 1979. View Article : Google Scholar : PubMed/NCBI
13	Martínez R, Reyes S and Menéndez R: Pulmonary nocardiosis: Risk factors, clinical features, diagnosis and prognosis. Curr Opin Pulm Med. 14:219–227. 2008. View Article : Google Scholar : PubMed/NCBI
14	Kurahara Y, Tachibana K, Tsuyuguchi K, Akira M, Suzuki K and Hayashi S: Pulmonary nocardiosis: A clinical analysis of 59 cases. Respir Investig. 52:160–166. 2014. View Article : Google Scholar : PubMed/NCBI
15	Mootsikapun P, Intarapoka B and Liawnoraset W: Nocardiosis in Srinagarind Hospital, Thailand: Review of 70 cases from 1996-2001. Int J Infect Dis. 9:154–158. 2005. View Article : Google Scholar : PubMed/NCBI
16	Zhang Z: Clinical Microbiology and Microorganism Analysis. Third edition. People Health Publishing House; Beijing: pp. pp226–pp229. 2003, (In Chinese).
17	Tam WO, Wong CF and Wong PC: Endobronchial nocardiosis associated with broncholithiasis. Monaldi Arch Chest Dis. 69:183–185. 2008.PubMed/NCBI
18	Menéndez R, Cordero PJ, Santos M, Gobernado M and Marco V: Pulmonary infection with Nocardia species: A report of 10 cases and review. Eur Respir J. 10:1542–1546. 1997. View Article : Google Scholar : PubMed/NCBI
19	Liping Wu, Yang Yi and Ting Liu: One case of pulmonary nocardiosis. Zhong Guo Kang Gan Ran Hua Liao Za Zhi. 5:117–118. 2005.(In Chinese).
20	Smego RA Jr and Gallis HA: The clinical spectrum of Nocardia brasiliensis infection in the United States. Rev Infect Dis. 6:164–180. 1984. View Article : Google Scholar : PubMed/NCBI
21	Kumar N and Ayinla R: Endobronchial pulmonary nocardiosis. Mt Sinai J Med. 73:617–619. 2006.PubMed/NCBI
22	Chedid MB, Chedid MF, Porto NS, Severo CB and Severo LC: Nocardial infections: Report of 22 cases. Rev Inst Med Trop Sao Paulo. 49:239–246. 2007. View Article : Google Scholar : PubMed/NCBI
23	Yuhua Wang, Qingjun Wu and Xiaofeng Zeng: Systemic lupus erythematosus complicating Nocardiosis: Two case reports and review of the literature. Beijing Yixue. 28:2652006.(In Chinese).
24	Munksgaard B: Nocardia infections. Am J Transplant. 4(Suppl 10): 47–50. 2004.PubMed/NCBI
25	BrownElliott BA, Ward SC, Crist CJ, Mann LB, Wilson RW and Wallace RJ Jr: In vitro activities of linezolid against multiple Nocardia species. Antimicrob Agents Chemother. 45:1295–1297. 2001. View Article : Google Scholar : PubMed/NCBI
26	Torres OH, Domingo P, Pericas R, Boiron P, Montiel JA and Vázquez G: Infection caused by Nocardia farcinica: Case report and review. Eur J Clin Microbiol Infect Dis. 19:205–212. 2000. View Article : Google Scholar : PubMed/NCBI
27	Martínez Tomás R, Menéndez Villanueva R, Reyes Calzada S, Santos Durantez M, Vallés Tarazona JM, Modesto Alapont M and Gobernado Serrano M: Pulmonary nocardiosis: Risk factors and outcomes. Respirology. 12:394–400. 2007. View Article : Google Scholar : PubMed/NCBI
28	Kandi V: Human Nocardia Infections: A Review of Pulmonary Nocardiosis. Cureus. 7:e3042015.PubMed/NCBI