title: Actinomycosis and nocardiosis co-infection in chronic granulomatous disease.
abstract: Chronic granulomatous disease (CGD) is an inherited disease of the phagocyte NADPH oxidase system that causes defective production of toxic oxygen metabolites, leading to impaired bacterial and fungal killing, and recurrent life threatening infections; mostly by catalase producing organisms. Nocardiosis in CGD is well described, however actinomycosis is rare. We describe a patient of CGD with actinomycosis and nocardiosis coinfection. A 43-year-old male with history of recurrent discharging sinuses presented with fever, dyspnea and cough. He had multiple discharging sinuses over neck and anterior chest wall. There was only partial response to intravenous penicillin. Needle aspirate from chest wall showed co-infection with actinomyces and nocardia. His nitroblue tetrazolium (NBT) reduction test was negative. He was treated with penicillin, amikacin and trimethoprim-sulfamethoxazole and had good clinical and radiological response.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi.
authors.forename: Manish
authors.initials: M
authors.lastname: Soneja
authors.forename: Atul
authors.initials: A
authors.lastname: Batra
authors.forename: Naval K
authors.initials: NK
authors.lastname: Vikram
authors.forename: Arvind
authors.initials: A
authors.lastname: Ahuja
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.forename: Rita
authors.initials: R
authors.lastname: Sood
mesh_terms: D000196:Actinomycosis / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D060085:Coinfection; D006105:Granulomatous Disease, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D009617:Nocardia Infections / Q000150:complications / Q000188:drug therapy*; D010404:Penicillin V / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000583:Amikacin; D010404:Penicillin V