Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 21006, People's Republic of China.
Department of Radiology, Nanjing Gaochun People's Hospital, Nanjing, Jiangsu, People's Republic of China.
BMC Infect Dis. 2021 Dec 7;21(1):1224. doi: 10.1186/s12879-021-06905-y.
Nocardia is a relatively rare opportunistic pathogenic bacteria group, commonly seen in patients with immunocompromised or defective immune system. It can affect multiple organs of the body and cause disseminated infection, among which most occurs in the lung, secondly in the nervous system, soft tissues, rare in the spinal cord and pituitary. No case has been reported involving lung, spinal cord, skin and pituitary gland at the same time.
We report a 55-year-old female with Nocardia infection involving the lung, skin, spinal cord, and pituitary gland. The patient underwent a full set of imaging examinations and showed typical imaging findings. Chest computed tomography (CT) showed multiple nodules with cavities in the lungs. The magnetic resonance imaging (MRI) of the vertebral body showed abnormal signal of the entire spinal cord with cavity formation and ring enhancement. The subcutaneous nodules of the abdomen were punctured under ultrasound. Through the etiological tissue culture of subcutaneous nodules and the second generation sequencing of cerebrospinal fluid, the diagnosis was finally confirmed.
Disseminated Nocardiosis is an uncommon disease. This article will report a rare case of disseminated Nocardiosis simultaneously involving the lung, spinal cord, subcutaneous soft tissue and pituitary gland, especially with neuropathy as the initial symptom. Imaging is helpful for the early diagnosis of the disease and pathological and microbiological examinations are helpful for its confirming.
奴卡菌是一种相对罕见的机会致病菌，常见于免疫功能受损或有缺陷的患者。它可影响人体多个器官并导致播散性感染，其中多数发生在肺部，其次是神经系统、软组织，脊髓和垂体罕见。尚无同时涉及肺部、脊髓、皮肤和垂体的病例报告。
我们报告了一例 55 岁女性患有奴卡菌感染，涉及肺部、皮肤、脊髓和垂体。患者进行了全套影像学检查，显示出典型的影像学表现。胸部计算机断层扫描（CT）显示肺部有多发性结节伴空洞。椎体磁共振成像（MRI）显示整个脊髓异常信号，伴有空洞形成和环状增强。在超声引导下对腹部皮下结节进行了穿刺。通过对皮下结节的病因组织培养和脑脊液第二代测序，最终确诊。
播散性奴卡菌病是一种罕见疾病。本文将报告一例罕见的同时涉及肺部、脊髓、皮下软组织和垂体的播散性奴卡菌病病例，特别是以神经病为首发症状。影像学检查有助于疾病的早期诊断，而病理和微生物学检查有助于确诊。
