Disseminated Nocardia Paucivorans Infection in an Immunocompetent Host

Overview

Journal Infection

Date 2014 Mar 18

PMID 24634088

Citations 9

Authors

M Hammoud

C Kraft

J Pulst-Korenberg

C Chenoweth

K S Gregg

Affiliations

Soon will be listed here.

Abstract

Nocardia paucivorans is a recently discovered species that has been shown to have a predilection for CNS involvement in cases of disseminated infection. We present a 50-year-old man with one year of weight loss admitted to the hospital with cough and confusion. Imaging revealed pulmonary and iliopsoas masses as well as innumerable ring-enhancing brain lesions. N. paucivorans was eventually identified in a subcarinal lymph node biopsy. The diagnosis was expedited by utilizing 16s rRNA gene sequencing on the biopsy tissue, resulting in species-level identification several weeks prior to culture positivity. He was treated with 12 months of parenteral and oral antibiotics, with resolution of pulmonary and brain lesions on repeat imaging.

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References

Xiao M, Kong F, Sorrell T, Cao Y, Lee O, Liu Y . Identification of pathogenic Nocardia species by reverse line blot hybridization targeting the 16S rRNA and 16S-23S rRNA gene spacer regions. J Clin Microbiol. 2009; 48(2):503-11. PMC: 2815619. DOI: 10.1128/JCM.01761-09. View

Wegerle S, Markus A, Weber N, Steffen H, King B, Eder W . [Pulmonary nocardiosis with trimethoprime/sulphamethoxazole-resistant Nocardia paucivorans in a patient with no signs of immunosuppression]. Pneumologie. 2007; 61(1):46-51. DOI: 10.1055/s-2006-944276. View

Corti M, Villafane-Fioti M . Nocardiosis: a review. Int J Infect Dis. 2003; 7(4):243-50. DOI: 10.1016/s1201-9712(03)90102-0. View

Beaman B, Beaman L . Nocardia species: host-parasite relationships. Clin Microbiol Rev. 1994; 7(2):213-64. PMC: 358319. DOI: 10.1128/CMR.7.2.213. View

Laurent F, Provost F, Boiron P . Rapid identification of clinically relevant Nocardia species to genus level by 16S rRNA gene PCR. J Clin Microbiol. 1998; 37(1):99-102. PMC: 84177. DOI: 10.1128/JCM.37.1.99-102.1999. View

Wellinghausen N, Pietzcker T, Kern W, Essig A, Marre R . Expanded spectrum of Nocardia species causing clinical nocardiosis detected by molecular methods. Int J Med Microbiol. 2002; 292(3-4):277-82. DOI: 10.1078/1438-4221-00208. View

Couble A, Rodriguez-Nava V, Perouse de Montclos M, Boiron P, Laurent F . Direct detection of Nocardia spp. in clinical samples by a rapid molecular method. J Clin Microbiol. 2005; 43(4):1921-4. PMC: 1081390. DOI: 10.1128/JCM.43.4.1921-1924.2005. View

Watson A, French P, Wilson M . Nocardia asteroides native valve endocarditis. Clin Infect Dis. 2001; 32(4):660-1. DOI: 10.1086/318712. View

Yassin A, Rainey F, Burghardt J, Brzezinka H, Mauch M, Schaal K . Nocardia paucivorans sp. nov. Int J Syst Evol Microbiol. 2000; 50 Pt 2:803-809. DOI: 10.1099/00207713-50-2-803. View

10.

LERNER P . Nocardiosis. Clin Infect Dis. 1996; 22(6):891-903; quiz 904-5. DOI: 10.1093/clinids/22.6.891. View

11.

Gray T, Serisier D, Gilpin C, Coulter C, Bowler S, McCormack J . Nocardia paucivorans--a cause of disseminated nocardiosis. J Infect. 2006; 54(2):e95-8. DOI: 10.1016/j.jinf.2006.05.005. View

12.

Anagnostou T, Arvanitis M, Kourkoumpetis T, Desalermos A, Carneiro H, Mylonakis E . Nocardiosis of the central nervous system: experience from a general hospital and review of 84 cases from the literature. Medicine (Baltimore). 2014; 93(1):19-32. PMC: 4616325. DOI: 10.1097/MD.0000000000000012. View

13.

Eisenblatter M, Disko U, Stoltenburg-Didinger G, Scherubl H, Schaal K, Roth A . Isolation of Nocardia paucivorans from the cerebrospinal fluid of a patient with relapse of cerebral nocardiosis. J Clin Microbiol. 2002; 40(9):3532-4. PMC: 130694. DOI: 10.1128/JCM.40.9.3532-3534.2002. View

14.

Lederman E, Crum N . A case series and focused review of nocardiosis: clinical and microbiologic aspects. Medicine (Baltimore). 2004; 83(5):300-313. DOI: 10.1097/01.md.0000141100.30871.39. View

15.

McNeil M, Brown J . The medically important aerobic actinomycetes: epidemiology and microbiology. Clin Microbiol Rev. 1994; 7(3):357-417. PMC: 358331. DOI: 10.1128/CMR.7.3.357. View

16.

Cloud J, Conville P, Croft A, Harmsen D, Witebsky F, Carroll K . Evaluation of partial 16S ribosomal DNA sequencing for identification of nocardia species by using the MicroSeq 500 system with an expanded database. J Clin Microbiol. 2004; 42(2):578-84. PMC: 344514. DOI: 10.1128/JCM.42.2.578-584.2004. View