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Infection

, Volume 46, Issue 5, pp 705–710 | Cite as

Disseminated nocardiosis caused by Nocardia elegans: a case report and review of the literature

  • Yi You
  • Wenchief Chen
  • Baiyu Zhong
  • Ziqiang Song
  • Xichuan Yang
Case Report
  • 141 Downloads

Abstract

Background

Disseminated nocardiosis is a rare disease mostly occurring in immunocompromised patients.

Methods

We report a case of disseminated nocardiosis in a diabetic patient with both pulmonary and cutaneous involvement. Nocardia elegans was isolated and identified using the 16s ribosomal RNA gene sequence data.

Results

Clinical improvement was observed within 3 months after initiation of antimicrobial treatment with oral doxycycline, trimethoprim-sulfamethoxazole and intravenous penicillin, but the patient died 5 months later after arbitrary discontinuation of the treatment.

Conclusions

This is the first case report of disseminated nocardiosis caused by Nocardia elegans in China.

Keywords

Nocardia elegans Nocardiosis 16s ribosomal RNA Gene sequencing 

Notes

Acknowledgements

We thank Danqi Deng (Dermatology Department of the Second Affilliated Hospital of Kunming Medical College), Yun Guo (Dermatology Deparment of the Second Affiliated Hospital of Kunming Medical College), Yongxia Wang (Yunnan Institute of Microbiology, Yunnan University,) and Xiaolong Cui (Yunnan Institute of Microbiology, Yunnan University) for assistance in the identification of the Nocardia species.

Funding

This study was supported by the National Natural Science Foundation of China (no. 81673058) and the Clinical Research Funding of Southwest Hospital (SWH2016JSTSYB-29).

Compliance with ethical standards

Conflict of interest

None declared.

References

  1. 1.
    Angeles RM, Lasala RP, Fanning CV. Disseminated subcutaneous nocardiosis caused by Nocardia farcinica diagnosed by FNA biopsy and 16S ribosomal gene sequencing. Diagn Cytopathol. 2008;36:266–9.CrossRefGoogle Scholar
  2. 2.
    Cui XL, Mao PH, Zeng M, et al. Streptimonospora salina gen. nov., sp. nov., a new member of the family Nocardiopsaceae. Int J Syst Evol Microbiol. 2001;51:357–63.CrossRefGoogle Scholar
  3. 3.
    Saitou N, Nei M. The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol. 1987;4:406–25.Google Scholar
  4. 4.
    Yassin AF, Brenner S. Nocardia elegans sp. nov., a member of the Nocardia vaccinii clade isolated from sputum. Int J Syst Evol Microbiol. 2005;55:1505–9.CrossRefGoogle Scholar
  5. 5.
    Nakamura I, Nagakura T, Fujita H, et al. Nocardia elegans infection: a case report and literature review. Int J Infect Dis. 2017;54:15–7.CrossRefGoogle Scholar
  6. 6.
    Liu WL, Lai CC, Ko WC, et al. Clinical and microbiological characteristics of infections caused by various Nocardia species in Taiwan: a multicenter study from 1998 to 2010. Eur J Clin Microbiol Infect Dis. 2011;30:1341–7.CrossRefGoogle Scholar
  7. 7.
    Watanabe K, Shinagawa M, Amishima M, et al. First clinical isolates of Nocardia carnea, Nocardia elegans, Nocardia paucivorans, Nocardia puris and Nocardia takedensis in Japan. Nippon Ishinkin Gakkai Zasshi. 2006;47:85–9.CrossRefGoogle Scholar
  8. 8.
    Harada H, Endo Y, Sekiguchi M, et al. Cutaneous nocardiosis in a cat. J Vet Med Sci. 2009;71:785–7.CrossRefGoogle Scholar
  9. 9.
    Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006;19:259–82.CrossRefGoogle Scholar
  10. 10.
    Wang X, Xiao M, Kong F, et al. Reverse line blot hybridization and DNA sequencing studies of the 16S–23S rRNA gene intergenic spacer regions of five emerging pathogenic Nocardia species. J Med Microbiol 2010;59:548–55.CrossRefGoogle Scholar
  11. 11.
    Alfaresi M, Elkosh A. Rapid identification of clinically relevant Nocardia species using real-time PCR with SYBR Green and melting-curve analysis. J Med Microbiol. 2006;55:1711–5.CrossRefGoogle Scholar
  12. 12.
    TBuckwalter SP, Olson SL, Connelly BJet al. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of Mycobacterium species, Nocardia species, and other aerobic actinomycetes. J Clin Microbiol. 2016;54:376–84.CrossRefGoogle Scholar
  13. 13.
    Tuo MH, Tsai YH, Tseng HK, et al. Clinical experiences of pulmonary and bloodstream nocardiosis in two tertiary care hospitals in northern Taiwan, 2000–2004. J Microbiol Immunol Infect. 2008;41:130–6.PubMedGoogle Scholar
  14. 14.
    Yildiz O, Doganay M. Actinomycoses and Nocardia pulmonary infections. Curr Opin Pulm Med. 2006;12:228–34.CrossRefGoogle Scholar
  15. 15.
    Munoz J, Mirelis B, Aragon LM, et al. Clinical and microbiological features of nocardiosis 1997–2003. J Med Microbiol. 2007;56:545–50.CrossRefGoogle Scholar
  16. 16.
    Minero MV, Marin M, Cercenado E, et al. Nocardiosis at the turn of the century. Medicine (Baltimore). 2009;88:250–61.CrossRefGoogle Scholar
  17. 17.
    Barrio MI, Martinez MC, Prados C, et al. Isolation of Nocardia species in patients with cystic fibrosis. Arch Bronconeumol 2008;44;109–12.CrossRefGoogle Scholar
  18. 18.
    Ooi Y, Shiba H, Nagai K, Higashiyama T, et al. Lung Nocardia elegans infection diagnosed on matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Intern Med 2014;53:2111–3.CrossRefGoogle Scholar
  19. 19.
    Masaki T, Ohkusu K, Ezaki T, Miyamoto H. Nocardia elegans infection involving purulent arthritis in humans. J Infect Chemother. 2012;18:386–9.CrossRefGoogle Scholar
  20. 20.
    Ueda Y, Yamamoto K, Watanabe K,et al. Obstructive pneumonia and brain abscess due to Nocardia elegans in a patient with systemic lupus erythematosus. Kansenshogaku Zasshi. 2014;88:282–7.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Yi You
    • 1
  • Wenchief Chen
    • 2
  • Baiyu Zhong
    • 1
  • Ziqiang Song
    • 1
  • Xichuan Yang
    • 1
  1. 1.Department of Dermatology, Southwest HospitalThird Military Medical UniversityChongqingChina
  2. 2.Department of Dermatology and AllergyTechnische Universitaet MuenchenMunichGermany

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