title: Nocardial infections: report of 22 cases.
abstract: Twenty-two cases of nocardial infections were diagnosed in our city between 1977- 1998. All patients whose clinical specimens showed Nocardia spp. at Gram stain, which were further confirmed by culture, were selected to be included in the study. Data from patients who were cured were compared with those from patients who died by statistical tests using EPIINFO version 6.04 software. Six isolates were identified as Nocardia asteroides complex, one as Nocardia asteroides sensu stricto and other as Nocardia brasiliensis. We had 17 cases of lung nocardiosis, being one out of them also a systemic disease. Other four cases of systemic nocardiosis were diagnosed: nocardial brain abscesses (one); nocardiosis of the jejunum (one); multiple cutaneous abscesses (one); and a case of infective nocardial endocarditis of prosthetic aortic valve. One patient had a mycetoma by N. brasiliensis. Fifteen (68.2%) out of 22 patients were immunosuppressed, being most (93.3%) by high-doses corticotherapy. Mortality by nocardial infection was 41%; mortality of systemic nocardiosis was 60%. Nocardiosis has a bad prognosis in immunosuppressed patients and also in non-immunosuppressed patients if the diagnosis is delayed. We propose that the delay in diagnosis should be examined in larger series to document its influence in the prognosis of the disease.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. mariab@terra.com.br
authors.forename: Maria Bernadete F
authors.initials: MB
authors.lastname: Chedid
authors.forename: Marcio F
authors.initials: MF
authors.lastname: Chedid
authors.forename: Nelson S
authors.initials: NS
authors.lastname: Porto
authors.forename: Cecília B
authors.initials: CB
authors.lastname: Severo
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Severo
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D020806:Central Nervous System Bacterial Infections / Q000382:microbiology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use