Disseminated Nocardia asiatica infection in an immunocompromised individual: A rare entity needs careful vigilance

J Infect Public Health. 2019 Mar-Apr;12(2):167-170. doi: 10.1016/j.jiph.2018.12.008. Epub 2019 Jan 28.

Abstract

Nocardia asteroides complex and Nocardia brasiliensis are common etiological agents of disseminated nocardiosis among immunocompromised individuals. Here we reported an uncommon case of disseminated nocardiosis with the involvement of lung, brain, soft tissue & pancreas by a rarely isolated species Nocardia asiatica in a HIV infected individual. Diagnosis was initially misinterpreted as tuberculosis based on the clinical and radiological findings. The isolate was identified to the species level with a 16S rRNA gene analysis & in vitro susceptibility was done as resistance is not uncommon among them. Clinical cure & radiological regression of lesions was observed except for brain after treatment with meropenem, amikacin & cotrimoxazole.

Keywords: HIV; Nocardia asiatica; Pancreatic abscess; disseminated nocardiosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Amikacin / administration & dosage
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • DNA, Ribosomal / chemistry
  • DNA, Ribosomal / genetics
  • HIV Infections / complications*
  • Humans
  • Immunocompromised Host*
  • Male
  • Meropenem / administration & dosage
  • Microbial Sensitivity Tests
  • Nocardia / classification
  • Nocardia / genetics
  • Nocardia / isolation & purification*
  • Nocardia Infections / diagnosis*
  • Nocardia Infections / drug therapy
  • Nocardia Infections / pathology*
  • RNA, Ribosomal, 16S / genetics
  • Sequence Analysis, DNA
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • DNA, Ribosomal
  • RNA, Ribosomal, 16S
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Amikacin
  • Meropenem