Malani Ashok Kumar, Gupta Chakshu, Weigand Robert T, Gupta Vicram, Rangineni Sandeep
Department of Hematology and Medical Oncology, Heartland Regional Medical Center, St. Joseph, Missouri, USA.
J Natl Med Assoc. 2006 Jun;98(6):977-9.
Nocardia farcinica is an uncommon cause of nocardiosis and usually infects immunocompromised individuals. We describe a patient with Hodgkin's disease and a thigh abscess due to N. farcinica. To the best of our knowledge, this has never been reported before in the English literature. It is important to recognize this complication, because a delay in diagnosis may result in widespread dissemination. Unless initially suspected, culture and identification will be delayed, as selective media for isolating Nocardia are not routinely used in most clinical laboratories. It is also important to differentiate N. farcinica from other Nocardia species due to its resistance to many antibiotics that are routinely used to treat abscesses, including cephalosporins. A case report along with literature review is presented in an effort to stress the importance of including this pathogen in the differential diagnosis of immunocompromised patients with abscesses.
鼻疽诺卡菌是诺卡菌病的一种罕见病因,通常感染免疫功能低下的个体。我们描述了一名患有霍奇金病且因鼻疽诺卡菌导致大腿脓肿的患者。据我们所知,此前英文文献中从未有过此类报道。认识到这种并发症很重要,因为诊断延迟可能导致广泛播散。除非最初就有所怀疑,否则培养和鉴定将会延迟,因为大多数临床实验室通常不使用用于分离诺卡菌的选择性培养基。由于鼻疽诺卡菌对许多常用于治疗脓肿的抗生素(包括头孢菌素)具有耐药性,因此将其与其他诺卡菌属菌种区分开来也很重要。本文通过病例报告及文献综述,强调了在免疫功能低下且患有脓肿的患者鉴别诊断中纳入这种病原体的重要性。