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[诺卡菌病,一种重要的机会性感染]

[Nocardiosis, an important opportunistic infection].

作者信息

Hoogeveen Mascha, Brouwer Rolf E, Bernards A Sandra T, Soetekouw Robin

机构信息

Medisch Centrum Haaglanden, discipline Interne Geneeskunde, Den Haag, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2010;154:A1177.

Abstract

In three patients, a 69-year-old woman, a 52-year-old woman and a 35-year-old man, nocardiosis was diagnosed. The first woman had chronic B-cell leukaemia and mucosal pemphigoid; she was on immunosuppressive medication, and had fever and a suppurative arthritis of the knee. The second woman was on immunosuppressive medication following a kidney transplantation and had fever and a pulmonary infiltrate. The male patient had hereditary cystic kidneys and a soft tissue infection of the left leg. He was not immunologically compromised. Nocardiosis is mainly an opportunistic bacterial infection but can also affect immune competent patients. The disease manifestations are protean, ranging from localised skin infections to severe systemic diseases, quite often with central nervous system involvement. Identifying the organism can be challenging, and notifying the laboratory when nocardiosis is suspected can help to optimise the diagnostic yield. Nocardiosis requires a long duration of medical therapy, trimethoprim-sulfonamide being the most frequently used antibiotic combination.

摘要

在三名患者中,分别为一名69岁女性、一名52岁女性和一名35岁男性,诊断出了诺卡菌病。第一名女性患有慢性B细胞白血病和黏膜类天疱疮;她正在接受免疫抑制治疗,出现发热和膝关节化脓性关节炎。第二名女性在肾移植后接受免疫抑制治疗,出现发热和肺部浸润。男性患者患有遗传性多囊肾和左腿软组织感染。他没有免疫功能受损。诺卡菌病主要是一种机会性细菌感染,但也可影响免疫功能正常的患者。该病的表现形式多样,从局部皮肤感染到严重的全身性疾病,常常累及中枢神经系统。鉴定该病原体可能具有挑战性,怀疑诺卡菌病时通知实验室有助于提高诊断率。诺卡菌病需要长期药物治疗,甲氧苄啶-磺胺甲恶唑是最常用的抗生素组合。

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