Feng Yan, Zuo Chun-Lei, Shi Jia-Xin
Department of Pulmonary and Critical Care Medicine, Lianyungang Clinical College of Nanjing Medical University, Lianyungang First People's Hospital, 6 East Zhenhua Road, Lianyungang, 222006, China.
Laboratory Department, Lianyungang Clinical College of Nanjing Medical University, Lianyungang First People's Hospital, 6 East Zhenhua Road, Lianyungang, 222006, China.
Open Life Sci. 2024 Feb 3;19(1):20220815. doi: 10.1515/biol-2022-0815. eCollection 2024.
Human brucellosis is an infectious disease caused by Brucella and is often misdiagnosed for atypical manifestations including fever of unknown origin, headache, weakness, among else. Nocardiosis is a zoonotic disease caused by the genus Nocardia, which usually spreads through the respiratory tract, skin, and digestive tract. Limited research has documented cases of co-infection involving both Brucella and Nocardia pathogens in patients. A 55-year-old male was admitted to our hospital with intermittent high-grade fever. Following sputum and blood cultures, as well as other laboratory examinations, the patient was diagnosed with concurrent brucellosis and nocardiosis. According to recommendations of previous studies and reports, the patient was successively treated with levofloxacin, doxycycline, piperacillin sodium and sulbactam sodium, trimethoprim-sulfamethoxazole, rifampicin, and tigecycline, after which the patient recovered and was discharged. Brucella and Nocardia are both opportunistic pathogens and simultaneous infection of Brucella and Nocardia is relatively rare. If patients continue to experience persistent fever despite receiving empirical antibiotic therapy, it becomes necessary to conduct examinations to identify potential atypical pathogens, including Brucella and Nocardia. Sputum staining, sputum culture, and blood culture are critical auxiliary examinations during clinical practice. The treatment plan should be selected based on guidelines and the individual patient's condition. Regular reevaluation should be conducted, and antimicrobial agents should be adjusted accordingly.
人类布鲁氏菌病是由布鲁氏菌引起的一种传染病，常因包括不明原因发热、头痛、乏力等非典型表现而被误诊。诺卡菌病是由诺卡菌属引起的一种人畜共患病，通常通过呼吸道、皮肤和消化道传播。仅有有限的研究记录了患者同时感染布鲁氏菌和诺卡菌病原体的病例。一名55岁男性因间歇性高热入住我院。经痰液和血液培养以及其他实验室检查，该患者被诊断为同时患有布鲁氏菌病和诺卡菌病。根据既往研究和报告的建议，该患者先后接受了左氧氟沙星、多西环素、哌拉西林钠舒巴坦钠、复方磺胺甲恶唑、利福平以及替加环素治疗，之后患者康复出院。布鲁氏菌和诺卡菌均为机会性病原体，布鲁氏菌和诺卡菌同时感染相对罕见。如果患者在接受经验性抗生素治疗后仍持续发热，则有必要进行检查以确定潜在的非典型病原体，包括布鲁氏菌和诺卡菌。痰液染色、痰液培养和血液培养是临床实践中的关键辅助检查。应根据指南和患者个体情况选择治疗方案。应定期进行重新评估，并相应调整抗菌药物。
