[Postoperative nocardiosis caused by Nocardia otitidiscaviarum: pitfalls and delayed diagnosis].
Nocardiosis is an uncommon infection, which is exceptionally present as a postoperative event. A case of postoperative pulmonary and cerebro-meningeal infection caused by Nocardia otitidiscaviarum after a leg amputation in a diabetic patient is reported. Diagnosis has been delayed and the clinical, radiological and microbiological causes of this delay are assessed from a quality of care management point of view. Recommendations are proposed regarding physicians' role and optimized microbiological procedures for recognition of slowly growing nocardial strains.
Bonnet
F
F
Service d'anesthésie-réanimation, Assistance publique-Hôpitaux de Paris, hôpital Saint-Louis, Paris, France. francine.bonnet@sls.aphp.fr <francine.bonnet@sls.aphp.fr>
Donay
J-L
JL
Fieux
F
F
Marie
O
O
de Kerviler
E
E
Jacob
L
L
D000368:Aged; D000671:Amputation, Surgical; D001922:Brain Abscess / Q000175:diagnosis / Q000382:microbiology; D048909:Diabetes Complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D024901:Drug Resistance, Multiple, Bacterial; D042241:Early Diagnosis; D019115:Fasciitis, Necrotizing / Q000150:complications; D017809:Fatal Outcome; D005602:France; D005734:Gangrene / Q000150:complications; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008302:Mali / Q000208:ethnology; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000382:microbiology; D009615:Nocardia / Q000254:growth & development / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis* / Q000382:microbiology; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000382:microbiology; D011379:Prognosis; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012422:Rupture, Spontaneous; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications; D013997:Time Factors