DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20190644

Multiple nodules accompanied by pulmonary nocardiosis in a patient with systemic lupus erythematosus

Rakesh Kumar Mahajan, Saumya Agarwal, Hishmi Jeram, Shukla Das

Abstract


Nocardia a common saprophyte of soil is an opportunistic pathogen that may cause invasive and disseminated infections in patients with compromised immune function. Pulmonary nocardiosis is one of the common invasive infections which may pursue a perilous course in patients with underlying chronic lung disease and patients on long term steroids. Any evidence of the presence of this organism even in potentially contaminated sample like sputum deserves due cognizance because of rare occurrence of Nocardia as laboratory contaminants. Identification and institution of appropriate therapy is absolutely critical to the positive clinical outcome of this otherwise fatal infection.


Keywords


Immunosuppressive therapy, Nocardia, Pulmonary nocardiosis

Full Text:

PDF

References


Mok CC, Yuen KY, Lau CS. Nocardiosis in systemic lupus erythematosus. Semin Arthritis Rheum. 1997;26:675-83.

Lee AY, Ogershok PR, Weisse ME. Persistent pneumonia in aboy with systemic lupus erythematosus. Clin Pediatr. 2002;41:443-6.

Hua KW, Wang HS, Chien CH, Yee CC, Mong HL, Wagner SL, et al. Clinical characteristics, microbiology, an outcomes for patients with lung and disseminated nocardiosis in a tertiary hospital. J Formosan Med Assoc. 2015;114:742-9.

Hui CH, Au VW, Rowland K, Slavotinek JP, Gordon DL. Pulmonary nocardiosis re-visited: experience of 35 patients at diagnosis. Respir Med. 2003;97:709-17.

Kofteridis D, Mantadakis E, Mixaki I, Stefanidou M, Maraki S, Alexandrakis M, et al. Primary cutaneous nocardiosis in 2 patients on immunosuppressants. Scand J Infect Dis 2005;37:507–10.

Filice GA, Niewoehner DE. Contribution of neutrophils and cellmediatedimmunity to control of Nocardia asteroides in murinelungs. J Infect Dis. 1987;156:113-21.

Agterof MJ, van der Bruggen T, Tersmette M, ter Borg EJ, vanden Bosch JM, Biesma DH. Nocardiosis: a case series and a mini review of clinical and microbiological features. Neth J Med. 2007;65:199–202.

Pintado V, Go´mez-Mampaso E, Fortu´n J, Meseguer MA, Cobo J, Navas E, et al. Infection with Nocardia species: clinical spectrum of disease and species distribution in Madrid, Spain, 1978–2001. Infection. 2002;30:338–40.

Castro JG, Espinoza L. Nocardia species infections in a large county hospital in Miami: 6 years experience. J Infect. 2007;54:358–61.

Mandell GL, Bennett JE, Dolin R. Nocardia species. Principles and practice of infectious diseases. 6th ed. Philadelphia: Churchill Livingstone; 2005.