title: Disseminated nocardiosis caused byNocardia otitidiscaviarumin an immunocompetent host: A case report and literature review.
abstract: The aim of the present study was to summarize the clinical characteristics of nocardiosis caused byNocardia otitidiscaviarumin order to improve the knowledge of nocardiosis. A case of dissemination nocardiosis caused byN. otitidiscaviarumin an immunocompetent host is reported and the associated literature reviewed. Informed consent for publication of this case report was provided by the patient. The present patient was a young immunocompetent man suffering from disseminated nocardiosis induced by infection withN. otitidiscaviarum. Following a poor response to β-lactam antibiotic, a combination of sulfonamide with minocycline was administered, which successfully ameliorated the symptoms. Previous studies published in English were retrieved from PubMed with 'Nocardia otitidiscaviarum' used as the search keyword. A total of 23 articles were retrieved from the PubMed database, supporting the assertion thatN. otitidiscaviarumis a rareNocardiaspecies. Among these 23 cases, there were 11 cases of lymphocutaneous (48%), 5 of pulmonary (22%), 2 of brain (9%) and 1 of pyothorax (4%) infection, and 4 cases of disseminated infections (17%). Analysis of the immune state of these patients demonstrated that 9 were immunocompetent (39%), 7 of whom had cutaneous infections (30%) with a predominant history of trauma (6/7), and 14 were immunosuppressed, 9 of whom were treated with prednisolone. Microbiology and histopathology were necessary in all cases for definite diagnosis. Among the 13 cases who underwent drug susceptibility testing, 10 cases were sensitive to trimethoprim-sulfamethoxazole (TMP-SMX) and 12 cases were sensitive to aminoglycoside. In conclusion, althoughN. otitidiscaviarumis one of the less commonly isolated species ofNocardia, it is capable of inducing localized or disseminated infection, even in an immunocompetent host. The majority of cases respond well to TMP-SMX and aminoglycoside, but the therapeutic action of cephalosporin is weak. Identification of bacteria and drug sensitivity tests forNocardiais critical for guiding clinical treatment.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China.
authors.forename: Yanwen
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China.
authors.forename: Aiben
authors.initials: A
authors.lastname: Huang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China.
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Fang
keywords: Nocardia otitidiscaviarum; disseminative; drug sensitivity; liver; lung; soft tissue; subcutaneous