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[Nocardial pulmonary infection].

S Couraud1, R Houot, M Coudurier

  • 1Service de pneumologie, Centre Hospitalier Lyon Sud, CHU Lyon, Pierre Bénite, France. scouraud@yahoo.fr

Revue Des Maladies Respiratoires
|April 10, 2007
PubMed
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Nocardial pneumonia, a rare infection caused by actinomycetes, primarily affects immunocompromised adults. Early suspicion and laboratory consultation are crucial for diagnosing this serious condition.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases

Background:

  • Nocardial pneumonias are caused by Nocardia, a genus of aerobic, filamentous, Gram-positive actinomycetes.
  • These infections are rare but significant in immunocompromised individuals.

Observation:

  • Two cases of nocardial pneumonia are presented in immunocompromised patients.
  • Case 1: A 62-year-old man post-bone marrow transplant for lymphocytic leukemia developed N. farcinica infection.
  • Case 2: A 61-year-old man on corticosteroids and chemotherapy presented with disseminated N. nova infection.

Findings:

  • Nocardia species can cause severe pulmonary infections, particularly in immunocompromised hosts.
  • Disseminated Nocardia infections can affect multiple organs, including the brain, pleura, lungs, and spleen.

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  • Diagnosis requires microbiological identification of the organism from clinical specimens.

    • Implications:

    • Nocardiosis should be suspected in immunocompromised patients with pleuro-pulmonary symptoms, especially when accompanied by neurological or cutaneous signs.
    • Prompt communication with the microbiology laboratory is essential for timely diagnosis and management.
    • Early detection and appropriate antimicrobial therapy are critical for favorable outcomes in nocardiosis.