2nd Department of Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Attikon General Hospital, 1 Rimini st., Haidari, Athens 12462, Greece.
Heart Lung. 2013 Jul-Aug;42(4):247-50. doi: 10.1016/j.hrtlng.2013.03.007. Epub 2013 May 14.
Pulmonary nocardiosis is an uncommon opportunistic infection affecting mainly immunocompromised patients. We herein present a case of nocardiosis without profound underlying immunodeficiency.
A female, 84-years' old patient with stage IV chronic obstructive pulmonary disease (COPD) is presented. No profound causes of immunodeficiency existed, such as HIV infection, diabetes mellitus, malignancy, alcoholism, chemotherapy or previous corticosteroid intake. The patient recovered after treatment with trimethoprim/sulfamethoxazole for 6 months.
One year after infection resolution, stimulation of the patient's blood monocytes with Nocardia antigens revealed defective production of tumor necrosis factor-alpha, interleukin (IL)-6 and IL-17.
We provide preliminary evidence for a link between defective innate immune responses and predisposition for Nocardia infections. Further studies must be conducted in order to fully investigate this mechanism of infection acquisition.
肺奴卡菌病是一种少见的机会性感染，主要影响免疫功能低下的患者。本文报告一例无严重潜在免疫缺陷的奴卡菌病病例。
一名 84 岁女性，患有 IV 期慢性阻塞性肺疾病（COPD）。不存在导致免疫缺陷的明显原因，如 HIV 感染、糖尿病、恶性肿瘤、酗酒、化疗或既往皮质类固醇摄入。患者接受甲氧苄啶/磺胺甲噁唑治疗 6 个月后康复。
在感染得到解决一年后，用奴卡菌抗原刺激患者的血液单核细胞，结果显示肿瘤坏死因子-α、白细胞介素（IL）-6 和 IL-17 的产生存在缺陷。
我们提供了固有免疫反应缺陷与奴卡菌感染易感性之间关联的初步证据。必须进行进一步的研究，以充分研究这种感染发生的机制。
