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The Journal of Dermatological Treatment Dec 2023To emphasize the role of non-sulfonamides in the treatment of Nocardia infection and reduce the adverse reactions caused by sulfonamides.
AIM
To emphasize the role of non-sulfonamides in the treatment of Nocardia infection and reduce the adverse reactions caused by sulfonamides.
METHODS
We retrospectively analyzed a case of cutaneous nocardiosis in an immunocompetent individual. The colonies obtained by staining the pus in the lesion with antacid and culturing the agar plates were identified by flight mass spectrometry. The pathogenic identification showed Nocardia brasiliensis infection and the patient was treated with amoxicillin-clavulanic acid.
RESULTS
After treatment with amoxicillin and clavulanic acid, the ulcer gradually peeled and crusted, leaving dark pigmentation. The patient has finally recovered.
CONCLUSION
Sulfonamides are the first-line antibacterial agents for years in treatment of nocardiosis but are of great toxicity and side effects. This patient was successfully treated with amoxicillin-clavulanic acid and it provided a reference protocol for patients with sulfonamide-resistant Nocardia or sulfonamides intolerance.
Topics: Nocardia; Nocardia Infections; Skin Diseases, Bacterial; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Treatment Outcome; Humans; Female; Aged, 80 and over
PubMed: 37394975
DOI: 10.1080/09546634.2023.2229467 -
Scientific Reports Mar 2024The purpose of the present study was to evaluate the in vitro activity of tedizolid against several clinically significant species of Nocardia by comparing with that of...
The purpose of the present study was to evaluate the in vitro activity of tedizolid against several clinically significant species of Nocardia by comparing with that of linezolid. A total of 286 isolates of Nocardia species, including 236 clinical isolates recovered from patients in Japan and 50 strains (43 species) purchased from NITE Biological Resource Center, were studied. Antimicrobial susceptibility testing was performed using the broth microdilution method. For the 286 Nocardia isolates, the minimal inhibitory concentration (MIC) and MIC values of tedizolid were 0.25 and 0.5 μg/ml, and those of linezolid were 2 and 2 μg/ml, respectively. The distribution of the linezolid/tedizolid ratios (MICs of linezolid/MICs of tedizolid) showed that tedizolid had four- to eight-fold higher activity than linezolid in 96.1% (275/286) of Nocardia isolates. Both the tedizolid and linezolid MIC values for Nocardia brasiliensis were two-fold higher than those for the other Nocardia species. Both tedizolid and linezolid had low MIC values, 0.25-1 μg/ml and 0.5-4 μg/ml, respectively, even against nine isolates (five species) that were resistant to trimethoprim/sulfamethoxazole. One Nocardia sputorum isolate showed reduced susceptibility to tedizolid (4 μg/ml). Bioinformatics analysis suggests different resistance mechanisms than the oxazolidinone resistance seen in enterococci and staphylococci.
Topics: Humans; Linezolid; Oxazolidinones; Tetrazoles; Nocardia
PubMed: 38438563
DOI: 10.1038/s41598-024-55916-7 -
Cureus Aug 2023We present a challenging case of disseminated infection manifesting as brain and skin abscesses. is an important potential pathogen to consider in patients with a...
We present a challenging case of disseminated infection manifesting as brain and skin abscesses. is an important potential pathogen to consider in patients with a relevant travel history to endemic regions or atypical presentations, such as brain and skin abscesses. About one-third of patients with infections are immunocompetent, and their symptoms are nonspecific. This case shows the limitations of imaging studies in diagnosing brain abscesses, as the patient's non-magnetic resonance (MR) conditional pacemaker precluded MRI evaluation and led to a diagnostic challenge. Therefore, the patient's initial evaluation was presumed to be primary lung cancer with brain metastasis. High clinical suspicion, imaging studies (especially MRI), and tissue biopsy are needed to diagnose this type of brain abscess in a timely manner to prevent further complications.
PubMed: 37719483
DOI: 10.7759/cureus.43631 -
Medicine Jan 2024Members of the genus Nocardia brasiliensis are Gram-positive, aerobic bacteria and exist ubiquitously in most environments. In recent years, the incidence of Nocardia...
RATIONALE
Members of the genus Nocardia brasiliensis are Gram-positive, aerobic bacteria and exist ubiquitously in most environments. In recent years, the incidence of Nocardia brasiliensis has increased significantly and become a global concern. It may be predominantly caused pulmonary infections in immunocompromised hosts. Interestingly, however, we found that it can be present not only on immunocompromised hosts, but also to infect patients with a normal immune system.
PATIENT CONCERNS
We report a very rare case of a 49-year-old immunocompetent man with disseminated Nocardia brasensis pneumonia. He had a fever for 14 days (maximum temperature about 38°C) and a history of mass rupture.
DIAGNOSES
Severe Disseminated Nocardia brasiliensis pneumonia with normal immune function.
INTERVENTIONS
No.
OUTCOMES
The patient was finally diagnosed with Severe Disseminated Nocardia brasiliensis pneumonia and received compound sulfamethoxazole treatment for 4 months.
LESSONS SUBSECTIONS
Our report highlights when cold pus appears in soft tissues such as the lower limbs, neck, nose, scalp, etc, should prompt timely evaluation and biopsy for definitive diagnosis. Be alert to a normally immunocompetent, disseminated Nocardia brasiliensis infection. Early recognition and effective treatment are necessary conditions for successful results. This would allow for better disease prognostication while enabling physicians to develop more effective treatment strategies.
Topics: Male; Humans; Middle Aged; Nocardia; Pneumonia; Nocardia Infections; Immunity
PubMed: 38181241
DOI: 10.1097/MD.0000000000036402 -
Asian Journal of Surgery Oct 2023
Topics: Humans; Nocardia; Brain Abscess; Pneumoconiosis
PubMed: 37211435
DOI: 10.1016/j.asjsur.2023.05.065 -
Asian Journal of Surgery May 2024
PubMed: 38760214
DOI: 10.1016/j.asjsur.2024.04.203 -
Respirology Case Reports Oct 2023is an aerobic Gram-positive bacterium found in the environment, including soil and water. is reportedly associated with cutaneous infections, and disseminated disease...
is an aerobic Gram-positive bacterium found in the environment, including soil and water. is reportedly associated with cutaneous infections, and disseminated disease is typically detected in immunocompromised individuals. We present a rare case of disseminated nocardiosis with in an immunocompetent patient. An 82-year-old male, who had a left elbow injury 2 months prior to the first visit, presented with bilateral multiple lung nodules. was identified in both sputum and pus specimens, we concluded that the had spread from the primary cutaneous lesion. The patient was treated with antibiotics and had a favourable clinical course. As the present case report demonstrates, disseminated nocardiosis caused by this species can progress from a primary cutaneous lesion even in immunocompetent individuals, if the initiation of appropriate treatment is delayed. Therefore, careful evaluation is warranted when species are detected.
PubMed: 37771846
DOI: 10.1002/rcr2.1227 -
Anales de Pediatria Dec 2023
Topics: Humans; Insect Bites and Stings; Lymphangitis; Nocardia; Skin Abnormalities; Soft Tissue Injuries
PubMed: 37598077
DOI: 10.1016/j.anpede.2023.08.005 -
Cureus Apr 2024, an opportunistic, gram-positive, catalase-positive, rod-shaped bacterium found in soil and water, is known to cause infections in humans, predominantly among...
, an opportunistic, gram-positive, catalase-positive, rod-shaped bacterium found in soil and water, is known to cause infections in humans, predominantly among immunocompromised individuals, through inhalation or direct inoculation. This report details a rare case of a septic joint caused by , which subsequently led to cutaneous involvement, in a patient with multiple underlying health issues. The management of this case was complicated by the patient's extensive medical history, including diabetes, chronic urinary tract infections, and recent surgical procedures, which necessitated a nuanced approach to antibiotic therapy. The treatment regimen underwent several adjustments in response to concurrent infections in other organs and the emergence of multidrug-resistant organisms. Despite an expanded arsenal of therapeutic options for infections, treating such infections remains challenging due to potential adverse outcomes, particularly in immunocompromised patients prone to infection relapse. This case underscores the complexities involved in diagnosing and managing infections and highlights the importance of tailored antibiotic therapy in achieving favorable outcomes while minimizing the risk of relapse.
PubMed: 38721187
DOI: 10.7759/cureus.57810