Maraki Sofia, Mavromanolaki Viktoria Eirini, Detorakis Efstathios E, Stafylaki Dimitra, Moraitis Panagiotis, Scoulica Effie
1Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71500 Heaklion, Crete, Greece.
2University of Crete Medical School, 70013 Heraklion, Crete, Greece.
Acta Microbiol Immunol Hung. 2022 Oct 3;69(4):351-357. doi: 10.1556/030.2022.01868. Print 2022 Dec 6.
Nocardia species are rare causative agents of psoas abscess, more frequently occurring as part of disseminated infection. Only sporadic cases have been reported so far, with Nocardia asteroides and Nocardia farcinica being the most common causative agents. Nocardia elegans is an opportunistic pathogen, accounting for only 0.3-0.6% of infections caused by Nocardia species, usually affecting the respiratory tract.In this study, a previously healthy 74-year-old man was admitted to the University Hospital of Heraklion with fever and intense pain radiating from the lumbar region to the groin and the left thigh, increasing with movement. Imaging findings revealed a large abscess in the left iliopsoas. Blood and pus aspirate cultures yielded a pure culture of Nocardia that was identified by 16S rRNA sequence as N. elegans. The patient was successfully treated with drainage of the abscess along with administration of ceftriaxone, linezolid and trimethoprim-sulfamethoxazole. To our knowledge, this is the first report of iliopsoas abscess caused by N. elegans. Early, accurate diagnosis and timely treatment with drainage of the abscess and long-term administration of antimicrobial agents optimize the outcome.
诺卡菌属是腰大肌脓肿的罕见病原体，更常见于播散性感染。迄今为止，仅报告过散发病例，其中星型诺卡菌和豚鼠耳炎诺卡菌是最常见的病原体。秀丽诺卡菌是一种机会致病菌，仅占诺卡菌属感染的0.3%-0.6%，通常累及呼吸道。在本研究中，一名74岁既往健康男性因发热以及从腰部向腹股沟和左大腿放射的剧痛入院，疼痛随活动加剧。影像学检查发现左髂腰肌有一个大脓肿。血液和脓液抽吸培养获得诺卡菌纯培养物，经16S rRNA序列鉴定为秀丽诺卡菌。患者通过脓肿引流以及使用头孢曲松、利奈唑胺和复方磺胺甲恶唑成功治愈。据我们所知，这是首例由秀丽诺卡菌引起的髂腰肌脓肿报告。早期、准确的诊断以及脓肿引流和长期使用抗菌药物的及时治疗可优化治疗结果。
