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At least 307 records · Page 17Linked to original sources
PubMed1992

Mediastinitis due to Nocardia asteroides after cardiac transplantation.

Nocardia infection classically occurs in immuno-compromized patients. Only a few cases of mediastinal infection due to this pathogen have been described in the literature. We report a patient who developed mediastinitis due to Nocardia asteroides after cardiac transplantation. The treatment was surgical debridement, dressing, sugaring and antibiotic therapy. The emergence of a severe acute renal failure possibly induced by drug interaction between Cyclosporin, cyclines and aminoglycosides, led us to modify the antimicrobial treatment. The intravenous use of Imipenem 2 g per day and Ciprofloxacin 400 mg per day for four weeks and then oral Ciprofloxacin 1.5 g per day for 1 year, was effective and allowed a good outcome, without any drug interaction with Cyclosporin, adverse effect, graft rejection episode or infection relapse.

Anti-Bacterial Agents↗
PubMed1996

Pyogranulomatous peritonitis associated with Nocardia sp.-like organisms in a raccoon (Procyon lotor).

During 1992 raccoons (Procyon lotor) were live-trapped in northeastern Pennsylvania (USA). In one of these animals a localized pyogranulomatous peritonitis was seen. Grossly a large mass with a central area of liquifactive necrosis was present in the anterior abdomen. Microscopically the lesion contained multiple colonies of filamentous organisms with histomorphologic and histochemical charcteristics resembling Nocardia sp. This appears to be the first report of Nocardia infection in the raccoon.

Animals↗
PubMed1999

Primary cutaneous nocardiosis in a husband and wife.

A 62-year-old woman suffered from acute purulent skin disease with multiple subcutaneous abscesses. At the same time, her 65-year-old husband presented with multiple subcutaneous nodules along the lymphatic vessels of his right arm. Both had a history of a minor scratch by a thorn of a bush at the site of infection. Nocardia was identified as causative bacterium from the woman's lesions. Therefore the rare phenomenon of 2 different forms of acute primary cutaneous nocardiosis after simultaneous infection, lymphocutaneous infection, and superficial skin infection was diagnosed.

Acute Disease↗
PubMed1989

Nocardial infections in renal transplant recipients.

Upon review of the English literature and the patients at our hospital, we identified 94 renal transplant recipients with nocardiosis. These patients were further evaluated and compared to nonrenal transplant patients with nocardiosis. We found that these patients were similar in presentation, course, and therapeutic outcome to non-transplant patients. Survival was related to underlying disease, site of infection, rapidity with which the diagnosis was made and, especially, the inclusion of a sulfa compound in the antimicrobial regimen. Transplant centers with high rates of Nocardia infection should consider trimethoprim/sulfamethoxazole prophylaxis for at least the first year after transplantation.

Adult↗
PubMed1997

Subcutaneous phaeohyphomycosis and nocardiosis in a kidney transplant patient.

Phaeohyphomycosis and nocardiosis are uncommon infections that are more frequently reported in immunocompromised patients. To our knowledge, this is the first report of subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei in association with systemic infection with Nocardia asteroides. The patient's phaeohyphomycosis responded to surgical excision and multi-drug therapy, and the patient underwent prolonged therapy with trimethoprim/sulfamethoxazole for treatment of the nocardiosis.

Dermatomycoses↗
PubMed1990

The radiographic appearance of pulmonary nocardiosis associated with AIDS.

Pulmonary nocardiosis is a well-described infection in immunocompromised patients; however, it is less well documented in patients with AIDS. The pulmonary manifestation in 21 HIV-positive patients who developed pulmonary infection with Nocardia asteroides is described. The radiographic picture included lobar or multilobar consolidation (52 percent [11/21]), solitary masses (24 percent [5/21]), reticulonodular infiltrates (33 percent [7/21]), and pleural effusion (33 percent [7/21]). Cavitation was common (62 percent [13/21]), and upper lobes were more commonly involved (71 percent [15/21]). Although the radiographic picture is variable, nocardiosis should be suspected in an HIV-positive patient who has subacute pulmonary disease with an unexplained lung mass or cavitary lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1982

[Sporotrichoid infection caused by Nocardia brasiliensis].

A few days after a spine of one of his indoor cacti had pricked the fourth finger of his left hand, a 56-year-old man developed multiple inflammatory suppurating nodules and infiltrates and a cord-like lymphangitis on the left forearm and upper arm. Nocardia brasiliensis was cultivated from aspirated pus. Subsequently, both Nocardia brasiliensis and Nocardia asteroides were isolated from the cactus earth. This is the first report of an infection by Nocardia brasiliensis acquired in Germany.

Arm↗
PubMed2006

Molecular diagnosis of Nocardia farcinica from a cerebral abscess.

Histopathology and special stains of a brain biopsy specimen from a 42-year-old man revealed numerous gram-positive bacilli arranged in branching filaments, suggesting Nocardia infection. Antibiotic therapy with trimethoprim-sulfamethoxazole markedly decreased the abscess size, and the patient improved. DNA was analyzed from formalin-fixed sections of the cerebral abscess by a 16S ribosomal DNA polymerase chain reaction assay demonstrating the presence of either Nocardia farcinica or N otitidiscaviarum. A species-specific polymerase chain reaction assay confirmed N farcinica as the etiologic agent.

Adult↗
PubMed2004

Isolated nocardial subcapsular and perinephric abscess.

We report a rare presentation of Nocardia infection in a 60 years old diabetic and cirrhotic patient who had perinephric and subcapsular renal abscess. This localized type of infection was successfully treated with oral cotrimoxazole.

Abscess↗
PubMedDate not supplied

CT features of pulmonary nocardiosis.

OBJECTIVE: Our goal was to identify the CT features of pulmonary nocardiosis, specifically in AIDS patients versus other immunocompromised hosts. MATERIALS AND METHODS: Twenty-four patients with pulmonary nocardiosis were identified; medical records, CT scans, and chest radiographs were reviewed. Five patients had HIV disease, 17 had other causes of immunosuppression, and 2 had normal immunity. RESULTS: CT features of pulmonary nocardiosis included one or more nodules/masses (20/24 cases, 83%), cavitation (8, 33%), consolidation/infiltrates (8, 33%), and pleural thickening (7, 29%). All AIDS patients with nocardiosis had multiple (four or more) nodules detected on CT and 80% (4/5) had cavitation compared with 21% each of non-AIDS patients (p < 0.01 for multiple nodules, p < 0.045 for cavitation). CONCLUSION: CT features of pulmonary nocardiosis are varied, and AIDS patients are more likely to display cavitation and multiple nodules. Although not widely recognized, Nocardia infection should be included in the differential diagnosis of an unexplained nodule or progressive cavitary process in HIV-positive patients.

AIDS-Related Opportunistic Infections↗
PubMed1973

An ultrastructural analysis of Nocardia during experimental infections in mice.

Several strains of Nocardia that varied from virulent to avirulent were injected intraperitoneally into young mice. Histological and ultrastructural analysis of the resultant infections revealed that the bacteria and the lesions they induced were different depending upon the strain of organism used. Further, the morphological and tinctorial characteristics of the bacteria grown in vitro changes during growth in vivo. These observations strongly suggested that chemical and physical alterations occurred in the cell envelope of the Nocardia when grown in mice. Electron microscopy confirmed that significant structural modification occurred, especially in the cell envelope, when the nocardial cells established themselves within the host tissue. It was shown that the least virulent strain exhibited the most dramatic changes whereas the most virulent organism appeared to be affected the least.

Animals↗
PubMed2003

Pulmonary nocardiosis in heart transplant recipients: treatment and outcome.

BACKGROUND: Nocardial infections typically affect patients receiving immunosuppressants, occurring early after surgery in 3% to 40% of heart transplant (HTx) recipients. The emergence of antibiotic resistance and occurrence of disease recurrences in AIDS population has engendered controversy about the treatment for immunodepressed HTx patients. METHODS: We present a retrospective study of the diagnosis, treatment and outcome of 560 HTx recipients between 1984 and 2002. RESULTS: Among the five cases of Nocardia infection (0.9%), three cases developed late after HTx (between 3.1 and 11 years follow-up). All patients had pulmonary disease and one in addition had subcutaneous nodules. Microbiological diagnosis required open lung biopsy in one case. All patients were treated primarily with trimethoprim-sulphamethoxazole, but evidence of resistance to sulfonamides led us to change the antimicrobial combination in two cases. Four patients who received one year of antibiogram-guided therapy showed complete healing without recidivism. Three patients died, all due to non-related causes, at follow-ups between 1 and 5 years. In one case a cutaneous recurrence of disease was attributed to noncompliance. CONCLUSIONS: Nocardiosis in current HTx is less common than previously reported. Its incidence seems to be delayed in time with modern immunosuppressants. Given the high incidence of sulfamide resistance, treatment must be guided by antibiotic sensitivity. We believe that maintenance therapy for a whole year is the appropriate option in order to avoid recidivism in this population.

Anti-Bacterial Agents↗
PubMed1996

Disseminated and cerebral infection due to Nocardia farcinica: diagnosis by blood culture and cure with antibiotics alone.

Systemic infections with Nocardia species continue to be a serious threat to immunosuppressed hosts. Diagnosis of these infections can be difficult despite their known tendency for cerebral and subcutaneous involvement. We describe a patient who presented with nonspecific constitutional symptoms and was found to have subcutaneous and cerebral abscesses due to Nocardia farcinica. In addition, a blood culture yielded the organism. The patient responded remarkably to oral therapy; resolution of the cerebral disease was observed on serial magnetic resonance images. We discuss the important clinical features on N. farcinica infection, the rarity of positive blood cultures, and the importance of susceptibility testing of Nocardia species in selecting drug therapy.

Anti-Bacterial Agents↗
PubMed1994

Ectopic ACTH syndrome with nocardiosis--a case report.

A 25-year-old man was admitted with chief complaints of multiple ecchymoses over face and both arms after a trivial trauma since one month before entry. Physically, he was thin without moon face, buffalo hump, or purple striae, while extensive fungus infection was present. Mild hyperglycemia, hypokalemic alkalosis were also found. Chest x-ray revealed multiple cavitary nodular lesions over bilateral lung fields. Needle biopsy from a rib lesion showed small cell carcinoma with strongly positive ACTH stain. The patient's basal cortisol level was greater than 62 micrograms/dl and failed to be suppressed by both low and high dose dexamethasone. The 24 hours urine free cortisol, 17 KS, and 17 OHCS were 8454 micrograms/24h, 49.8 mg/24h, and 50.8 mg/24h respectively. His plasma ACTH level was 725 pg/ml and remained high (1210 pg/ml) after high dose dexamethasone suppression. On the 10th day after admission, the patient's general condition got worse rapidly. Fever, dyspnea developed with progression of the lung lesions. Nocardia infection was proved. He expired three days later in spite of antibiotics and ketoconazole treatment.

ACTH Syndrome, Ectopic↗
PubMed1998

Primary cerebellar nocardiosis and alveolar proteinosis.

We report a patient with known asymptomatic pulmonary alveolar proteinosis (PAP) who developed a cerebellar gait disorder and dysarthria caused by an isolated cerebellar nocardial abscess. To our knowledge only 1 patient with PAP and isolated central nervous system nocardia infection has previously been reported. In this early report, diagnosis was established at autopsy. In our patient the clinical and MRI examinations of this cerebellar abscess are described and specific features leading to earlier diagnosis and successful treatment are presented.

Brain Abscess↗