title: A case of community-acquired pneumonia due to influenza A virus and Nocardia farcinica co-infection.
abstract: Nocardia spp. has not been reported previously as a cause of post-influenza pneumonia. Here we present a first case of post-influenza bacterial pneumonia due to Nocardia farcinica. Initial reason for hospitalization of the 90 year old female patient was a pneumonia with the symptoms of fever and productive cough. A rapid test for influenza antigen was positive for influenza A virus. Treatment with Zanamivir and piperacillin was initiated. However, after 1 week of treatment, the infiltration shadows on chest X-ray had worsened. Because the expectorated sputum collected on admission for culture was found to be positive for Nocardia spp., piperacillin was replaced with trimethoprim/sulfamethoxazole, and a chest X-ray showed some improvement. Although pulmonary nocardiosis with co-infection with influenza A is extremely rare, clinicians should be alert to the possibility.
authors.affiliation: Department of Respiratory Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan. Electronic address: toyosawai@yahoo.co.jp.
authors.forename: Toyomitsu
authors.initials: T
authors.lastname: Sawai
authors.affiliation: Department of Respiratory Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
authors.forename: Sumako
authors.initials: S
authors.lastname: Yoshioka
authors.affiliation: Department of Respiratory Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Matsuo
authors.affiliation: Department of Respiratory Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Suyama
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D060085:Coinfection; D017714:Community-Acquired Infections; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human; D009615:Nocardia; D009617:Nocardia Infections; D018410:Pneumonia, Bacterial; D013902:Radiography, Thoracic; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Co-infection; Influenza; Nocardia farcinica; Post-influenza bacterial pneumonia