Bao Lianmin, Lin Heping, Dong Ling, Zhang Qing, Shangguan Zongxiao
Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Respiratory Clinical Laboratory, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Coll Physicians Surg Pak. 2019 Mar;29(3):278-280. doi: 10.29271/jcpsp.2019.03.278.
Nocardia species usually cause opportunistic infections, and the frequency of these infections is increasing owing to the growing population of immunocompromised hosts. However, Nocardia may sometimes causes an infectious disease in immunocompetent hosts. Herein, we report two cases of pulmonary nocardiasis in immunocompetent individuals, whose chest computed tomography (CT) findings mimicked bronchiectasis. Samples of bronchalveolar lavage (BAL) fluid obtained by bronchoscopy showed filamentous, branching, gram-positive rods, acid-fast filamentous branching rods, and a colony of suspected Nocardia was cultured. Based on 16sRNA and hsp65 gene sequence analysis, case 1 was identified as N. cyriacigeorgica, but case 2 was not matched. The patients responded well to treatment with the combination of sulfamethoxazole and linezolid.
诺卡菌属通常引起机会性感染，由于免疫功能低下宿主人群的增加，这些感染的发生率正在上升。然而，诺卡菌有时也可能在免疫功能正常的宿主中引起传染病。在此，我们报告两例免疫功能正常个体的肺诺卡菌病病例，其胸部计算机断层扫描（CT）表现类似支气管扩张。通过支气管镜获得的支气管肺泡灌洗（BAL）液样本显示有丝状、分支状、革兰氏阳性杆菌、抗酸丝状分支杆菌，且培养出疑似诺卡菌的菌落。基于16sRNA和hsp65基因序列分析，病例1被鉴定为乔治亚州诺卡菌，但病例2不匹配。患者接受磺胺甲恶唑和利奈唑胺联合治疗后反应良好。
