title: Nocardia and Lungs in COPD: Beyond Immuno-deficiencies.
abstract: Nocardia is an opportunistic pathogen and Pulmonary Nocardiosis (PN) occurred in more than half of the cases in subjects with immuno-suppressed status. COPD is one of the most common comorbidity observed in immuno-competent patients with PN. In this perspective study, we report the clinical patterns, the outcomes and the comorbidities of all cases of PN admitted in our Unit in the years 1999-2012. Among 6545 patients admitted in our Unit during the study time, we identified PN in 4 patients. COPD was coexistent in 3 out of 4 cases. A delayed time for the diagnosis was observed. Clinical-radiological improvement was detected in all cases after one month of specific anti-PN therapy. According to our experience, PN is a rare disease that should be suspected also in immuno-competent patients. COPD is confirmed to be a risk factor for the development of PN, probably due to reduced respiratory defenses and prolonged steroid therapy.
authors.affiliation: 1Pulmonology and Respiratory Intensive Care Unit, S. Donato Hospital , Arezzo , Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Maggiorelli
authors.forename: Irene
authors.initials: I
authors.lastname: Di Pierro
authors.forename: Carmen
authors.initials: C
authors.lastname: Manta
authors.forename: Uberto
authors.initials: U
authors.lastname: Maccari
authors.forename: Irene
authors.initials: I
authors.lastname: Galanti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: COPD; immunocompetent host; nocardia; pneumonia