Bacteremia and adrenal gland abscess due to Nocardia cyriacigeorgica: a case report and review

BMC Infect Dis. 2022 Dec 29;22(1):966. doi: 10.1186/s12879-022-07839-9.

Abstract

Background: Nocardia cyriacigeorgica is one of the most common Nocardia species found in human infections, recently reclassified. Even though Nocardia may affect all organs by hematogenous dissemination, bacteremia are uncommon. Among all possible dissemination sites, the involvement of the adrenal glands is particularly rare.

Case presentation: We report here a rare case of Nocardia disseminated infection with notably bacteremia and adrenal gland abscess, in a 77-years-old immunocompetent man. Adrenal gland abscess diagnosis was made by imaging (computerized tomography, magnetic resonance and positron emission tomography scan). A complete regression of all lesions including the left adrenal gland was obtained after 6 months of antibiotics. A review of literature was also performed.

Conclusion: Nocardia bacteremia is a rare event but blood cultures may help to improve detection of Nocardia spp. in a non-invasive way. Adrenal abscess due to Nocardia spp. is very rare with only fourteen cases reported in the literature, but it is a true cause of adrenal masses. Our report suggests that clinician should be aware of this rare location and prioritize a non-invasive diagnosis strategy.

Keywords: Adrenal gland abscess; Bacteremia; Nocardia cyriacigeorgica; Nocardiosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abscess / drug therapy
  • Adrenal Glands / diagnostic imaging
  • Adrenal Glands / pathology
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / complications
  • Bacteremia* / diagnosis
  • Bacteremia* / drug therapy
  • Humans
  • Male
  • Nocardia Infections* / diagnosis
  • Nocardia Infections* / drug therapy
  • Nocardia*

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Nocardia cyriacigeorgica