Disseminated Nocardia farcinica infection in a Patient with Pneumoconiosis

Authors
1 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran,Iran.
2 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
3 Department of Clinical Microbiology, School of Medicine, Shahid BeheshtiUniversity of Medical Sciences, Tehran, IR Iran
4 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of MedicalSciences, Tehran, IR Iran
Abstract
Background: Nocardia as a Gram-positive bacillus with a microscopic appearance of branching hyphae can produce considerable disease in an appropriable host. N. facinica is a member of genus Nocardia that is potentially life threatening; therefore, therapy of N. farcinica infection remains difficult.
Case presentation: This study is a case report of disseminated N. farcinica infection in a 64-year-old man with a history of pneumoconiosis with brain, lung, and skin involvement in Labbafi Nejad hospital, Tehran, IR Iran in November 2013 with a discussion about diagnosis and management of this particular patient.
Conclusion: Due to the involvement of brain, triple therapy was started with meropenem, amikacin, and linezolid.

Keywords






















































































1. Budzik JM, Hosseini M, Mackinnon Jr AC, Taxy JB. Disseminated Nocardia farcinica: Literature review and fatal outcome in an immunocompetent patient. Surg Infect. 2012; 13(3):163-170.
https://doi.org/10.1089/sur.2011.012
 
2. Saubolle MA, Sussland D. Nocardiosis review of clinical and laboratory experience.J Clin Microbiol. 2003. 41(10):4497-501.
https://doi.org/10.1128/JCM.41.10.4497-4501.2003
 
3. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006; 19(3):259-82.
https://doi.org/10.1128/CMR.19.2.259-282.2006
 
4. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America.Clin infect Dis. 2010; 50(3):291-322.
https://doi.org/10.1086/649858
 
5. Roth A, Andrees S, Kroppenstedt RM, Harmsen D, Mauch H. Phylogeny of the genus Nocardia based on reassessed 16SrRNA gene sequences reveals under speciation and division of strains classified as Nocardia asteroides into three established species and two unnamed taxons. J Clin Microbiol. 2003; 41(2):851-856.
https://doi.org/10.1128/JCM.41.2.851-856.2003
 
6. Penkert H, Delbridge C, Wantia N, wiester B, Korn T. Fulminant central nervous system nocardiosis in a patient treated with alemtuzumab for relapsing-remitting multiple sclerosis. JAMA Neurol. 2016: 73(6):757-9
https://doi.org/10.1001/jamaneurol.2016.0146
 
7. Boiron P, Provost F, Chevrier G, Dupont B. Review of nocardial infections in France 1987 to 1990. Eur J Clin Microbiol Infect Dis. 1992; 11(8):709-14.
https://doi.org/10.1007/BF01989975
 
8. McNeil M, Brown J. Nocardia species (Nocardiosis). Antimicrob Ther Vaccine, 2002; 1:481-500.
 
9. Wade WA, Petsonk EL, Yong B, Mogri I. Severe occupational pneumoconiosis among west virginian coal miners: One hundred thirty-eight cases of progressive massive fibrosis compensated between 2000 and 2009. Chest. 2011; 139:1458-62.
https://doi.org/10.1378/chest.10-1326
 
10. Kim S, Lee KL, Lee DM, Jeong JH, Moon SM, Seo YH, et al. Nocardia brain abscess in an immunocompetent patient. Infect Chemother. 2014; 46(1):45-9
https://doi.org/10.3947/ic.2014.46.1.45
 
11. Tremblay J, Thibert L, Alarie I, Valiquette L, Pépin J. Nocardiosis in Quebec, Canada, 1988–2008. Clin Microbiol Infect. 2011; 17(5):690-6.
https://doi.org/10.1111/j.1469-0691.2010.03306.x
 
12. Valdezate S, Garrido N, Carrasco G, Villalón P, Medina-Pascual MJ, Saéz-Nieto JA. Resistance gene pool to co-trimoxazole innon-susceptible Nocardia strains. Front Microbial. 2015; 6:376
https://doi.org/10.3389/fmicb.2015.00376
 
13. Viganò SM, Edefonti A, Ferraresso M, Ranzi ML, Grossi P, Righini A, et al. Successful medical treatment of multiple brain abscesses due to Nocardia farcinica in a paediatric renaltransplant recipient. Pediatr Nephrol. 2005; 20(8):1186-8
https://doi.org/10.1007/s00467-005-1978-6
 
14. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006; 19(2): 259-82.
https://doi.org/10.1128/CMR.19.2.259-282.2006