Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis

Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbi...

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Bibliographic Details
Published inThe Brazilian journal of infectious diseases Vol. 15; no. 4; pp. 384 - 386
Main Authors Castelli, Jussara Bianchi, Siciliano, Rinaldo Focaccia, Abdala, Edson, Aiello, Vera Demarchi
Format Journal Article
LanguageEnglish
Portuguese
Published Brazilian Society of Infectious Diseases 01.08.2011
Elsevier
Subjects
endocarditis, bacterial
INFECTIOUS DISEASES
mitral valve
Nocardia infections
mitral valve
endocarditis, bacterial
Nocardia infections
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Summary:Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IE caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients.
ISSN:1413-8670
1678-4391
DOI:10.1590/S1413-86702011000400015