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一名患有特发性血小板减少性紫癜的免疫功能低下患者发生的经瓦莱（地区）诺卡菌播散性感染

Nocardia transvalensis Disseminated Infection in an Immunocompromised Patient with Idiopathic Thrombocytopenic Purpura.

作者信息

García-Méndez Jorge, Carrillo-Casas Erika M, Rangel-Cordero Andrea, Leyva-Leyva Margarita, Xicohtencatl-Cortes Juan, Arenas Roberto, Hernández-Castro Rigoberto

机构信息

Departamento de Posgrado y Educación Médica Continua, Instituto Nacional de Cancerología, Mexico; Departamento de Microbiología, Facultad de Medicina, UNAM, 04510 Coyoacán, MEX, Mexico.

Departamento de Biología Molecular e Histocompatibilidad, Dirección de Investigación, Hospital General "Dr. Manuel Gea González", 14080 Tlalpan, MEX, Mexico.

出版信息

Case Rep Infect Dis. 2016;2016:3818969. doi: 10.1155/2016/3818969. Epub 2016 May 24.

DOI:10.1155/2016/3818969
PMID:27313917
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4894989/
Abstract

Nocardia transvalensis complex includes a wide range of microorganisms with specific antimicrobial resistance patterns. N. transvalensis is an unusual Nocardia species. However, it must be differentiated due to its natural resistance to aminoglycosides while other Nocardia species are susceptible. The present report describes a Nocardia species involved in an uncommon clinical case of a patient with idiopathic thrombocytopenic purpura and pulmonary nocardiosis. Microbiological and molecular techniques based on the sequencing of the 16S rRNA gene allowed diagnosis of Nocardia transvalensis sensu stricto. The successful treatment was based on trimethoprim-sulfamethoxazole and other drugs. We conclude that molecular identification of Nocardia species is a valuable technique to guide good treatment and prognosis and recommend its use for daily bases diagnosis.

摘要

德兰士瓦奴卡菌复合体包括多种具有特定抗菌耐药模式的微生物。德兰士瓦奴卡菌是一种不常见的奴卡菌属物种。然而，由于它对氨基糖苷类天然耐药，而其他奴卡菌属物种敏感，因此必须加以区分。本报告描述了一株奴卡菌，它与一名患有特发性血小板减少性紫癜和肺奴卡菌病的患者的罕见临床病例有关。基于16S rRNA基因测序的微生物学和分子技术得以确诊为严格意义上的德兰士瓦奴卡菌。成功的治疗基于甲氧苄啶-磺胺甲恶唑及其他药物。我们得出结论，奴卡菌属物种的分子鉴定是指导良好治疗和预后的一项有价值的技术，并建议将其用于日常诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae0f/4894989/291eb252ac4e/CRIID2016-3818969.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae0f/4894989/0604da6fcff1/CRIID2016-3818969.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae0f/4894989/291eb252ac4e/CRIID2016-3818969.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae0f/4894989/0604da6fcff1/CRIID2016-3818969.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae0f/4894989/291eb252ac4e/CRIID2016-3818969.002.jpg

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本文引用的文献

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Lung India. 2012 Jul;29(3):283-5. doi: 10.4103/0970-2113.99121.
2
Nocardia transvalensis keratitis: an emerging pathology among travelers returning from Asia.从亚洲返回的旅行者中出现的诺卡氏菌性角膜炎：一种新兴病理学。
BMC Infect Dis. 2011 Oct 31;11:296. doi: 10.1186/1471-2334-11-296.
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Clinical and microbiological characteristics of infections caused by various Nocardia species in Taiwan: a multicenter study from 1998 to 2010.
台湾地区不同诺卡菌属引起的感染的临床和微生物学特征：1998 年至 2010 年的一项多中心研究。
Eur J Clin Microbiol Infect Dis. 2011 Nov;30(11):1341-7. doi: 10.1007/s10096-011-1227-9. Epub 2011 Apr 3.
4
Clinical and microbiological characteristics of Nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998-2008.1998-2008 年台湾地区诺卡菌病（包括新型诺卡菌所致感染）的临床与微生物学特征。
Clin Microbiol Infect. 2010 Jul;16(7):966-72. doi: 10.1111/j.1469-0691.2009.02950.x. Epub 2009 Oct 22.
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Nocardial infections in Japan from 1992 to 2001, including the first report of infection by Nocardia transvalensis.1992年至2001年日本的诺卡菌感染情况，包括首例创伤诺卡菌感染报告
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