Nocardia beijingensis pulmonary infection successfully treated with intravenous beta-lactam antibiotics and oral minocycline

Abstract We report a case of pulmonary infection caused by a rare Nocardia species, Nocardia beijingensis , in a 48-year-old man who received multiple immunosuppressive therapy after renal transplantation. This pathogen was isolated from a bronchoscopic protected specimen brush and was identified as...

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Published inJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 17; no. 5; pp. 706 - 709
Main Authors Ogawa, Taku, Kasahara, Kei, Yonekawa, Shinsuke, Nakagawa, Chiyo, Maeda, Koichi, Konishi, Mitsuru, Mikasa, Keiichi, Kikuchi, Ken
Format Journal Article
LanguageEnglish
Published Japan Elsevier Ltd 01.10.2011
Springer Japan
Subjects
Administration, Oral
Anti-Bacterial Agents - therapeutic use
Beta-lactam antibiotics
Case Report
Ceftriaxone - therapeutic use
Hematology, Oncology and Palliative Medicine
Humans
Immunosuppressive Agents
Infectious Diseases
Injections, Intravenous
Kidney Transplantation
Male
Medical Microbiology
Medicine
Medicine & Public Health
Middle Aged
Minocycline
Minocycline - therapeutic use
Nocardia
Nocardia - isolation & purification
Nocardia beijingensis
Nocardia Infections - diagnosis
Nocardia Infections - drug therapy
Pulmonary nocardiosis
Trimethoprim-sulfamethoxazole
Virology
Minocycline
Trimethoprim-sulfamethoxazole
Nocardia beijingensis
Pulmonary nocardiosis
Beta-lactam antibiotics
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Summary:Abstract We report a case of pulmonary infection caused by a rare Nocardia species, Nocardia beijingensis , in a 48-year-old man who received multiple immunosuppressive therapy after renal transplantation. This pathogen was isolated from a bronchoscopic protected specimen brush and was identified as N. beijingensis by 16S rRNA gene sequence analysis. The patient was initially treated with imipenem/cilastatin followed by ceftriaxone and oral minocycline. Traditionally, trimethoprim-sulfamethoxazole (SXT) has been one of the first-line antibiotics chosen as an initial therapy for pulmonary nocardiosis, but this case was successfully treated without SXT. Considering recent reports about failures of both prophylaxis and treatment for nocardial infections with SXT and its various side effects, treatment with beta-lactam antibiotics and minocycline for pulmonary nocardiosis can be chosen in mild to moderate cases with confirmed susceptibility to these antibiotics in vitro.
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ISSN:1341-321X
1437-7780
DOI:10.1007/s10156-011-0233-2