title: Impact of immune status on the clinical characteristics and treatment outcomes of nocardiosis.
abstract: Nocardiosis occurs in both immunocompromised and immunocompetent patients. We aimed to assess how its characteristics differ depending on patients' immune status. Of a total of 54 patients with culture-proven nocardiosis diagnosed over 13 years, 18 (33%) were immunocompetent. Half of immunocompetent patients had chronic lung disease and were not receiving systemic corticosteroid. There were no significant differences in clinical, radiographic, and microbiologic characteristics, and treatment outcomes according to immune status, except that pulmonary cavitation (47% vs. 8%) and coexisting infections (17% vs. 0%) were more frequent in immunocompromised hosts. Nocardia farcinica, the most commonly identified isolates at the species level (51%), was highly susceptible to trimethoprim-sulfamethoxazole (100%) and highly resistant to ceftriaxone (94%). Nocardiosis should be considered in differential diagnosis of pneumonia, brain abscess, or soft tissue infection that does not respond to conventional antibiotic therapy such as ceftriaxone, regardless of whether the patient is immunocompromised or not.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea.
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Heungsup
authors.initials: H
authors.lastname: Sung
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Jung
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Shi Nae
authors.initials: SN
authors.lastname: Yu
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Sung-Han
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: drchong@amc.seoul.kr.
authors.forename: Yong Pil
authors.initials: YP
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009615:Nocardia / Q000187:drug effects / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Coexisting infection; Immune status; Nocardia farcinica; Nocardiosis; Pulmonary cavitation