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免疫功能低下个体中的播散性亚洲诺卡菌感染:一种罕见的实体需要谨慎警惕。

Disseminated Nocardia asiatica infection in an immunocompromised individual: A rare entity needs careful vigilance.

机构信息

Department of Microbiology, Manipal Academy of Higher Education, Manipal, India.

Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

出版信息

J Infect Public Health. 2019 Mar-Apr;12(2):167-170. doi: 10.1016/j.jiph.2018.12.008. Epub 2019 Jan 28.

Abstract

Nocardia asteroides complex and Nocardia brasiliensis are common etiological agents of disseminated nocardiosis among immunocompromised individuals. Here we reported an uncommon case of disseminated nocardiosis with the involvement of lung, brain, soft tissue & pancreas by a rarely isolated species Nocardia asiatica in a HIV infected individual. Diagnosis was initially misinterpreted as tuberculosis based on the clinical and radiological findings. The isolate was identified to the species level with a 16S rRNA gene analysis & in vitro susceptibility was done as resistance is not uncommon among them. Clinical cure & radiological regression of lesions was observed except for brain after treatment with meropenem, amikacin & cotrimoxazole.

摘要

星型诺卡氏菌复合体和巴西诺卡氏菌是免疫功能低下人群中播散性诺卡氏菌病的常见病原体。在此,我们报道了一例罕见的艾滋病感染者感染罕见分离株亚洲诺卡氏菌引起肺、脑、软组织和胰腺播散性诺卡氏菌病的病例。根据临床和影像学发现,最初误诊为结核病。该分离株通过 16S rRNA 基因分析鉴定到种的水平,体外药敏试验表明,其中耐药性并不罕见。在使用美罗培南、阿米卡星和复方磺胺甲噁唑治疗后,临床治愈,除了脑部病变外,影像学也有所改善。

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