Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (3): 59-63.doi: 10.6040/j.issn.1671-7554.0.2021.0092

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Pulmonary infection caused by Nocardia pneumoniae and Nocardia amamiensis: a case report and literature review

AN Yuanxiaoxue1, DU Yiming2, TIAN Tian1, ZHANG Yi1, XUE Yuwen1   

  1. 1. Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong, China
  • Published:2022-03-09

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Abstract: Objective To describe the clinical characteristics and treatment options of Nocardia pneumoniae and Nocardia amamiensis pulmonary infection. Methods The clinical characteristics and treatment option of a patient with Nocardia pneumoniae and Nocardia amamiensis pulmonary infection were collected and analyzed. A series of relevant literature was reviewed. Results The patient was an immunocompromised host and had structural lung disease. The clinical manifestations were fever, expectoration and dyspnea. Chest CT showed multiple nodules, masses and consolidation in both lungs, with cavity formation, protrusions on the wall of cavity and liquid pneumothorax. The pathogens were identified as Nocardia pneumoniae and Nocardia amamiensis by BALF mNGS and pleural fluid bacteria culture with mass spectrometry analysis. Both of the bacteria were susceptible to linezolid, trimethoprim-sulfamethoxazole, imipenem and ceftriaxone, and resistant to quinolones. Conclusion Nocardia pneumoniae and Nocardia amamiensis are important pathogens of pulmonary infection. Combined linezolid and imipenem with trimethoprim-sulfamethoxazole is an effective anti-infection therapy.

Key words: Pulmonary infection, Nocardia pneumoniae, Nocardia amamiensis, Metagenomic next-generation sequencing, Antibiotics

CLC Number: 

  • R519
[1] Weng SS, Zhang HY, Ai JW, et al. Rapid detection of Nocardia by next-generation sequencing[J]. Front Cell Infect Microbiol, 2020, 10: 13. doi:10.3389/fcimb.2020.00013.
[2] Kageyama A, Yazawa K, Mukai A, et al. Nocardia araoensis sp. nov. and Nocardia pneumoniae sp. nov., isolated from patients in Japan[J]. Int J Syst Evol Microbiol, 2004, 54(Pt 6): 2025-2029.
[3] Yamamura H, Tamura T, Sakiyama Y, et al. Nocardia amamiensis sp. nov., isolated from a sugar-cane field in Japan[J]. Int J Syst Evol Microbiol, 2007, 57(Pt 7): 1599-1602.
[4] Fatahi-Bafghi M. Nocardiosis from 1888 to 2017[J]. Microb Pathog, 2018, 114: 369-384. doi: 10.1016/j.micpath.2017.11.012.
[5] Conville PS, Brown-Elliott BA, Smith T, et al. The complexities of Nocardia taxonomy and identification[J]. J Clin Microbiol, 2017, 56(1): e01419-01417.
[6] Beaman BL, Burnside J, Edwards B, et al. Nocardial infections in the United States, 1972-1974[J]. J Infect Dis, 1976, 134(3): 286-289.
[7] Lynch JP, 3rd, Reid G, Clark NM. Nocardia spp.: a rare cause of pneumonia globally[J]. Semin Respir Crit Care Med, 2020, 41(4): 538-554.
[8] Lafont E, Conan PL, Rodriguez-Nava V, et al. Invasive Nocardiosis: disease presentation, diagnosis and treatment-old questions, new answers?[J]. Infect Drug Resist, 2020, 13: 4601-4613. doi: 10.2147/IDR.S249761.
[9] Yu JE, Azar AE, Chong HJ, et al. Considerations in the diagnosis of chronic granulomatous disease[J]. J Pediatric Infect Dis Soc, 2018, 7(suppl_1): S6-S11.
[10] Ercibengoa M, Càmara J, Tubau F, et al. A multicentre analysis of Nocardia pneumonia in Spain: 2010-2016[J]. Int J Infect Dis, 2020, 90: 161-166. doi: 10.1016/j.ijid.2019.10.032.
[11] Abe S, Tanabe Y, Ota T, et al. Case report: pulmonary nocardiosis caused by Nocardia exalbida in an immunocompetent patient[J]. BMC Infect Dis, 2021, 21(1): 776.
[12] Wang T, Jia Y, Chu B, et al. Nocardiosis in kidney disease patients under immunosuppressive therapy: case report and literature review[J]. Int J Med Sci, 2019, 16(6): 838-844.
[13] Kato K, Noguchi S, Naito K, et al. Pulmonary Nocardiosis caused by Nocardia exalbida in a patient with lung cancer and radiation pneumonitis: a case report and literature review[J]. Intern Med, 2019, 58(11): 1605-1611.
[14] 余仙娟,何飞,汝触会. 播散性天美奴卡菌病一例临床分析并文献复习[J]. 浙江中西医结合杂志, 2020, 30(5): 413-416.
[15] 中华医学会检验医学分会临床微生物学组,中华医学会微生物学与免疫学分会临床微生物学组,中国医疗保健国际交流促进会临床微生物与感染分会.宏基因组高通量测序技术应用于感染性疾病病原检测中国专家共识[J].中华检验医学杂志, 2021, 44(2): 107-120. Clinical Microbiology Group of Chinese Society of Laboratory Medicine, Clinical Microbiology Group of Chinese Society of Microbiology and Immunology, Society of Clinical Microbiology and Infection of China International Exchange and Promotion Association for Medical and Healthcare. Chinese expert consensus on metagenomics next-generation sequencing application on pathogen detection of infectious diseases[J]. Chinese Journal of Laboratory Medicine, 2021, 44(2): 107-120.
[16] Gu W, Miller S, Chiu CY. Clinical metagenomic next-generation sequencing for pathogen detection[J]. Annu Rev Pathol, 2019, 14: 319-338. doi: 10.1146/annurev-pathmechdis-012418-012751.
[17] Betrán A, Villuendas MC, Rezusta A, et al. Clinical significance, antimicrobial susceptibility and molecular identification of Nocardia species isolated from children with cystic fibrosis[J]. Braz J Microbiol, 2016, 47(3): 531-535.
[18] Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy[J]. Clin Microbiol Rev, 2006, 19(2): 259-282.
[19] Hansen G, Swanzy S, Gupta R, et al. In vitro activity of fluoroquinolones against clinical isolates of Nocardia identified by partial 16S rRNA sequencing[J]. Eur J Clin Microbiol Infect Dis, 2008, 27(2): 115-120.
[20] Yi M, Wang L, Xu W, et al. Species distribution and antibiotic susceptibility of Nocardia isolates from Yantai, China[J]. Infect Drug Resist, 2019, 12: 3653-3661. doi: 10.2147/IDR.S232098.
[21] Huang L, Chen X, Xu H, et al. Clinical features, identification, antimicrobial resistance patterns of Nocardia species in China: 2009-2017[J]. Diagn Microbiol Infect Dis, 2019, 94(2): 165-172.
[22] Valdezate S, Garrido N, Carrasco G, et al. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain[J]. J Antimicrob Chemother, 2017, 72(3): 754-761.
[23] Lebeaux D, Bergeron E, Berthet J, et al. Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015[J]. Clin Microbiol Infect, 2019, 25(4): 489-495.
[24] Uhde KB, Pathak S, McCullum I Jr, et al. Antimicrobial-resistant nocardia isolates, United States, 1995-2004[J]. Clin Infect Dis, 2010, 51(12): 1445-1448.
[25] Davidson N, Grigg MJ, McGuinness SL, et al. Safety and outcomes of linezolid use for Nocardiosis[J]. Open Forum Infect Di, 2020, 7(4): ofaa090.
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