Nocardia cyriacigeorgica: a case of endocarditis with disseminated soft-tissue infection.
Nocardia cyriacigeorgica is a common environmental organism. It has been isolated from clinical samples in Europe, Asia and North America, predominantly from respiratory samples but also from samples from several other sites. We present a case report of an 85-year-old female patient in the UK who was found to have a multi-focal soft-tissue infection from which N. cyriacigeorgica was isolated. She had a background history of chronic obstructive pulmonary disease and corticosteroid use for polymyalgia rheumatica. During the course of her treatment echocardiography showed the presence of a mobile heart mass attached to a valve leaflet, a major Dukes criterion for endocarditis. We suggest that in cases of disseminated Nocardia infection, endocarditis should be tested for, particularly in cases failing to respond to treatment. We also review previous reports of both N. cyriacigeorgica infection, and of endocarditis due to Nocardia species and related genera.
Cargill
James S
JS
Department of Microbiology, Harrogate and District Hospital, Lancaster Park Road, Harrogate, North Yorkshire, HG2 7SX, UK.
Boyd
Gavin J
GJ
Department of Microbiology, Harrogate and District Hospital, Lancaster Park Road, Harrogate, North Yorkshire, HG2 7SX, UK.
Weightman
Nigel C
NC
Department of Microbiology, Harrogate and District Hospital, Lancaster Park Road, Harrogate, North Yorkshire, HG2 7SX, UK.
D000038:Abscess / Q000382:microbiology; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009615:Nocardia / Q000145:classification*; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents