Pulmonary nocardiosis re-visited: experience of 35 patients at diagnosis

• Published in: Respiratory medicine Vol. 97; no. 6; pp. 709 - 717
• Main Authors: HUI, C.H., AU, V.W.K., ROWLAND, K., SLAVOTINEK, J.P., GORDON, D.L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.06.2003; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Female; Human bacterial diseases; Humans; Infectious diseases; Lung Diseases - complications; Lung Diseases - diagnostic imaging; Lung Diseases - microbiology; Male; Medical sciences; Middle Aged; Nocardia Infections - complications; Nocardia Infections - diagnostic imaging; Nocardia Infections - microbiology; Opportunistic Infections - complications; Opportunistic Infections - diagnostic imaging; Opportunistic Infections - microbiology; Pneumology; Prognosis; pulmonary nocardiosis; Retrospective Studies; Tomography, X-Ray Computed; pulmonary nocardiosis; Human; Lung disease; Diagnosis; Pulmonary nocardiosis; Respiratory disease; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1053/rmed.2003.1505

Pulmonary infection by Nocardia is an uncommon opportunistic infection in humans. Thirty-five patients with pulmonary nocardiosis were identified in two tertiary referral hospitals. A retrospective review of the patient characteristics, clinical and laboratory features including antimicrobial susceptibility at diagnosis was carried out. Radiological features derived from chest radiographs and CT scans were also documented. In our population, the predominant risk factors were immuno-compromised state, corticosteroid therapy, and underlying pulmonary pathology. The presenting features were similar to those previously described but disseminated infection was not common. The radiological changes were diverse and non-specific. Nocardia asteroides was the commonest species. Most Nocardia isolates were susceptible to imipenem, ceftriaxone, amikacin, and cotrimoxazole. Co-existing microbial agents are common and reflect the underlying complex disorders.