We introduce the case of a male patient in his 60s who was admitted to our emergency department with a persisting sore throat for the last 3 weeks and dysphagia. Fibre-endoscopic evaluation revealed an asymmetry at the base of the tongue. In combination with elevated white cell count and C reactive protein, a computerized tomography showed a superinfected thyroglossal duct cyst. Intravenous antibiotics were initiated, and the patient was taken to the operating room for cervicotomy. The microbiological swab taken intraoperatively detected Additional imaging revealed disseminated nocardiosis with cerebral and pulmonary manifestations.The patient was treated with oral trimethoprim/sulfamethoxazole and, over time, showed complete remission of central nervous system lesions and improvement of pulmonary involvement. Following this, the treatment was stopped 8 months after the initial diagnosis. In this report, we discuss treatment standards and outcomes of nocardiosis based on our management strategies of our patient.
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http://dx.doi.org/10.1136/bcr-2024-259725 | DOI Listing |
Medicine (Baltimore)
December 2024
Department of Pulmonary and Critical Care Medicine, The Third People's Hospital of Chengdu, Chengdu, China.
Rationale: Nocardia infections, although rare, pose significant challenges in diagnosis and treatment, especially when involving the central nervous system (CNS). Mortality rates in such cases can be high, highlighting the need for early recognition and tailored antimicrobial therapy.
Patient Concerns: A 58-year-old male with a history of chronic obstructive pulmonary disease, antineutrophil cytoplasmic antibody-associated glomerulonephritis, and steroid-induced diabetes mellitus presented with disorganized speech, fever, cough, dyspnea, and psychiatric symptoms.
S Afr J Infect Dis
November 2024
Department of Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Unlabelled: Nocardiosis is a rare opportunistic infection and may be misdiagnosed as tuberculosis in the immunocompromised patient. This case report highlights the importance of doing tissue cultures in immunocompromised individuals to correctly identify spp. and initiate appropriate treatment timeously.
View Article and Find Full Text PDFItal J Pediatr
December 2024
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
Background: Nocardiosis is an opportunistic infection that has a low prevalence rate, its clinical manifestations are atypical and can be easily misdiagnosed as other diseases. The correct diagnosis and treatment are frequently delayed by various factors. In this case report, we present a pediatric patient with Neuromyelitis Optica Spectrum Disorders who developed Nocardia farcinica pneumonia complicated by pneumocystis jiroveci infection.
View Article and Find Full Text PDFMedicina (Kaunas)
November 2024
Department V, Internal Medicine I, Center for Advanced Research in Cardiovascular Pathology and Haemostaseology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 300041 Timisoara, Romania.
is an emerging bacterial disease that often affects patients with compromised immune systems. As the number of patients undergoing solid organ transplants continues to rise, and as more cancer survivors are treated with long-term immune-modifying agents, corticosteroids, and immunosuppressive medications, organisms that typically pose no harm are becoming a public health concern. Carbapenems are usually a second-line therapy in the setting of infections.
View Article and Find Full Text PDFInfection
November 2024
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Purpose: The prolonged treatment recommended for nocardiosis does not rely on strong evidence. Consequently, some clinicians opt shorter therapy in certain circumstances. We assessed the effectiveness of shorter therapy.
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