scholarly journals Cerebral Nocardiosis in a patient with Waldenstrom’s Macroglobulinaemia

2008 ◽  
Vol 7 (3) ◽  
pp. 128-130
Author(s):  
Patrick Tapley ◽  
◽  
Tanya G Cranfield ◽  
Godwin K Simon ◽  
◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Gram Positive ◽  
Nocardia Species ◽  
Brain Abscesses ◽  
Cerebral Nocardiosis ◽  
Waldenstrom’S Macroglobulinaemia

Abstract Nocardiosis is caused by nocardia species, a Gram positive aerobic filamentous bacillus. It is ubiquitous in the environment and often presents as pulmonary disease in more than 70% of patients.1 Dissemination of the disease may manifest as brain abscesses, and is reported to account for approximately 2% of all brain abscesses.2,3 We present a case of cerebral nocardiosis in a patient with Waldenstrom’s macroglobulinaemia, previously unreported in the literature…

Nocardiosis With Brain Abscess Due to an Unusual Species, Nocardia transvalensis

2003 ◽  
Vol 127 (2) ◽  
pp. 224-226 ◽  
Author(s):  
Rebecca F. Yorke ◽  
Emilie Rouah
Keyword(s):  
Early Identification ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Subsequent Development ◽  
Pulmonary Involvement ◽  
Antibiotic Susceptibility Testing ◽  
Nocardia Species ◽  
Pathologic Findings ◽  
Brain Abscesses ◽  
Clinically Significant

Abstract The identification of Nocardia transvalensis, an unusual and probably underrecognized cause of nocardial infection, is clinically significant because of this species' resistance to aminoglycosides, a standard antinocardial therapy. Diagnosis requires analytic methods available predominately in reference laboratories. We report a case of disseminated infection with N transvalensis with primary pulmonary involvement and subsequent development of brain abscesses, and review the literature to date. Familiarity with the epidemiology, pathologic findings, and clinical significance of this and other unusual Nocardia species may increase early identification and antibiotic susceptibility testing in cases of nocardial infection.

Nocardiosis

2020 ◽  
pp. 1176-1179
Author(s):  
Roderick J. Hay
Keyword(s):  
Antibiotic Treatment ◽  
Deep Infection ◽  
Nocardia Asteroides ◽  
Immunocompromised Patients ◽  
Healthy Individuals ◽  
Gram Positive ◽  
Nocardia Species ◽  
Lung Infections ◽  
The Tropics

Nocardia species—Nocardia asteroides, N. brasiliensis, and N. otidiscaviarum—are Gram-positive, filamentous, partially acid-fast bacteria. They are occasionally detectable in environmental sources such as soil, but they rarely cause infections in humans, although they can give rise to a variety of different diseases. In healthy individuals, most commonly in the tropics, they can present with cutaneous abscesses or subcutaneous infections (actinomycetoma) in which the organisms are present as clusters of filaments or grains. In immunocompromised patients they cause a disseminated or localized deep infection, with particular sites affected being the lungs or brain. Diagnosis of Nocardia infection depends on culture, although histopathology is very useful in Nocardia actinomycetomasiii. Antibiotic treatment is typically with a sulphonamide (often as co-trimoxazole for lung infections), but combinations of drugs are usually given because the responsiveness of Nocardia species is very variable.

Pulmonary Nocardia beijingensis infection associated with the use of alemtuzumab in a patient with multiple sclerosis

2017 ◽  
Vol 23 (6) ◽  
pp. 872-874 ◽  
Author(s):  
Marwan Sheikh-Taha ◽  
Lourdes C Corman
Keyword(s):  
Multiple Sclerosis ◽  
Pulmonary Infection ◽  
Immunocompromised Patients ◽  
Gram Positive ◽  
Nocardia Species

Nocardia is a Gram-positive aerobic pathogen that usually affects immunocompromised patients. We report a case of pulmonary infection caused by a rare Nocardia species, Nocardia beijingensis, in a 50-year-old woman who had received alemtuzumab for the treatment of her multiple sclerosis. The invasive pulmonary infection was successfully treated with meropenem.

scholarly journals 1084. Nocardia Cyriacigeorgica Endocarditis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S324-S325
Author(s):  
Nikhil Bhayani ◽  
Jaclyn Priest
Keyword(s):  
Dna Sequencing ◽  
Suppressive Therapy ◽  
Nocardia Asteroides ◽  
Chronic Obstructive ◽  
Gram Positive ◽  
Obstructive Pulmonary Disease ◽  
Nocardia Cyriacigeorgica ◽  
The Family ◽  
Brain Abscesses ◽  
Slow Growing

Abstract Background Nocardia are beaded, branching Gram-positive rods that are partially acid fast and usually slow growing. Nocardia cyriacigeorgica was first described in 2001, and antimicrobial susceptibility patterns correspond with type VI Nocardia asteroides complex. Nocardia species are not a commonly associated with endocarditis, less than 20 cases to date have been documented. However, when Nocardia endocarditis is identified, the mortality rate is reported to be as high as 41% making antibiotic selection vital in the inpatient and outpatient Methods A 62-year-old male with a past medical history significant for severe chronic obstructive pulmonary disease (COPD), atrial fibrillation, atrial tachyarrhythmia, and congestive heart failure (CHF) presented to the emergency department (ED) with shortness of breath for 1 week. The patient was initiated on IV diltiazem, meropenem, and eventually required intubation. On hospital day, two blood cultures grew Gram-positive rods, which were eventually identified as aerobic Actinomycete. Culture was sent out for DNA sequencing and N. cyriacigeorgica was identified. Transthoracic echocardiogram showed possible mitral vegetation. Results Antimicrobial therapy was initially de-escalated from meropenem to ampicillin, but had to be escalated to ceftriaxone once N. cyriacigeorgica was identified by DNA sequencing. The organism was reported to be susceptible to amikacin, ceftriaxone, linezolid, tobramycin, and trimethoprim/sulfamethoxazole. The patient received 1 week of ceftriaxone therapy inpatient, and was discharged on an additional 3 weeks of ceftriaxone and 6 months of minocycline suppressive therapy. Two months later the patient was re-admitted for N. cyriacigeorgica bacteremia and a pulmonary embolism. During his hospital stay, the patient had a STEMI, but due to multiple comorbidities did not undergo cardiac catheterization. The family elected to withdrawal care, and the patient expired. Conclusion N. cyriacigeorgica is more commonly identified in brain abscesses or skin infections, in the setting of immunosuppression. We report here on an unusual case of N. cyriacigeorgica endocarditis in a patient with COPD. Other than COPD the patient had no known risk factors for N. cyriacigeorgica, including chronic steroid use. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Presentation, Management, and Outcomes of Patients With Brain Abscess due to Nocardia Species

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Cristina Corsini Campioli ◽  
Natalia E Castillo Almeida ◽  
John C O’Horo ◽  
Douglas Challener ◽  
John Raymond Go ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Health Care Providers ◽  
Case Reports ◽  
Dual Therapy ◽  
Source Control ◽  
Care Providers ◽  
Nocardia Species ◽  
Cutaneous Infections ◽  
Small Series ◽  
Brain Abscesses

Abstract Background Nocardial brain abscesses are rare, and published literature describing brain abscesses due to Nocardia species is limited to individual case reports or small series. We report one of the largest contemporary retrospective studies describing risk factors, diagnostic evaluation, management, and outcomes of nocardial brain abscess. Methods Retrospective review of all adults with brain abscess due to culture-confirmed Nocardia species at our institution between January 1, 2009, and June 30, 2020. Results Overall, 24 patients had nocardial brain abscesses during the study period. The median age at presentation was 64 years, and 62.5% were immunocompromised. Pulmonary and cutaneous infections were the most common primary sites of nocardial infection. All 24 patients had magnetic resonance imaging performed, and the frontal lobe was the most commonly involved. The most common organism isolated was Nocardia farcinica, followed by Nocardia wallacei and Nocardia cyriacigeorgica. Thirteen patients were managed with antimicrobial therapy alone, while 11 had both medical and surgical management. In all patients, dual therapy was recommended for the initial 6 weeks of treatment, and 22 patients received at least 1 oral agent as part of their final antibiotic regimen, predominantly trimethoprim-sulfamethoxazole and linezolid. Fourteen patients achieved complete clinical and radiographic resolution of infection. Conclusions Nocardia is an important cause of brain abscess in the immunocompromised host. Early diagnostic and therapeutic aspiration may help health care providers confirm the diagnosis, choose an appropriate antimicrobial regimen, and achieve source control.

scholarly journals MYCOBACTERIA AND OTHER ACID FAST ORGANISMS ASSOCIATED WITH PULMONARY DISEASE IN JOS, NIGERIA PULMONARY DISEASE AND ACID FAST ORGANISMS

2015 ◽  
Vol 3 (1) ◽  
pp. 15
Author(s):  
Ani AE ◽  
Diarra B ◽  
Dahle UR ◽  
Lekuk C ◽  
Yetunde F ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Diagnostic Procedures ◽  
Adult Patients ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Tuberculosis Complex ◽  
Nocardia Species ◽  
Genotype Assay ◽  
Prompt Diagnosis

Objective: Acid fast bacilli (AFB) for sputum smear microscopy is the affordable method used for prompt diagnosis of tuberculosis in Nigeria despite its lack of specificity and limited sensitivity. The study aims to identify Mycobacterium tuberculosis and other acid fast organisms isolated from sputum of of HIV positive adult patients with pulmonary disease in Jos, Nigeria. Methods: Acid fast organisms isolated from 80 AFB positive sputa of HIV positive adult patients suspected for tuberculosis in Jos, Nigeria were identified for members of M. tuberculosis Complex (M tuberculosis, M bovis, M africanum, M canetti M. microti and M. caprae) by use of spoligootyping, Multiplex Gen Probe, Hain genotype assay and gene sequencing for spoligotype negative isolates. Results: Seven different spoligotypes of M. tuberculosis complex were identified from 70/80 (87.5%) total number of isolates. M. kansasii (1), M. dulvalii (1) Nocardia species (1) and Tsukamurella species (2) were detected from 5/10 spoligotype negative isolates. Conclusion and Recommendation: Although M. tuberculosis is the dominant AFB associated with chronic pulmonary disease in Jos, Nigeria, other clinically relevant mycobacteria were observed in the study. This suggests that other AFB positive microorganisms associated withtuberculosis -like symptoms could be misdiagnosed and incorrectly treated as M. tuberculosis. It is therefore necessary for laboratories in TB high burden countries to step up diagnostic procedures beyond routine smear microscopy.

Nonmucoid gram-negative Pseudomonas rods can readily be observed in cystic fibrosis patients' smears stained by the PATS reaction

1991 ◽  
Vol 49 ◽  
pp. 268-269 ◽  
Author(s):  
B.L. Giammara ◽  
R.L. Hopfer ◽  
J.S. Hanker
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Disease ◽  
Pulmonary Insufficiency ◽  
Pulmonary Infections ◽  
Good Source ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Deep Blue ◽  
Large Numbers

Cystic fibrosis(CF) is responsible for much of the chronic pulmonary disease seen in children. Progressive pulmonary insufficiency accompanied by respiratory tract infection is the cause of death in 90% of CF patients. Although gram-positive staphylococci were responsible for most of these pulmonary infections prior to 1960, gram-negative Pseudomonas aeruginosa(PA) colonization is now the major cause of the progressive pulmonary disease responsible for the morbidity and mortality in CF patients. Sputum has long been used for cultural purposes for CF patient evaluation. It has not been a good source for Gram stain specimens inasmuch as large numbers of deep blue gram-positive bacteria (Fig. 1) can overlie and mask the smaller numbers of pink or red rods such as PA which are being sought in the stained smear.

scholarly journals 1416. Nocardia beijingensis: A Rare and Unusual Cause of Intracranial Abscess

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S515-S516
Author(s):  
Lakshpaul Chauhan ◽  
Nirali Vassa ◽  
Elizabeth Henderson ◽  
Ateeq Mubarik ◽  
Danish Siddiq ◽  
...  
Keyword(s):  
Vasogenic Edema ◽  
Cranial Nerves ◽  
The United States ◽  
Immunocompetent Patient ◽  
Gram Positive ◽  
Scalp Lesion ◽  
Low Glucose ◽  
Cerebral Nocardiosis ◽  
Disseminated Nocardiosis

Abstract Background Nocardia species are thin, aerobic, filamentous, gram-positive bacilli that are ubiquitous in soil worldwide. Nocardia infections are divided into three main categories: pulmonary nocardiosis, disseminated nocardiosis, and cutaneous nocardiosis. Methods We present a case of cerebral nocardiosis in an immunocompetent patient caused by Nocardia beijingensis (NB). Results A 60-year-old Caucasian lady from Florida with type 2 diabetes mellitus, hypertension, hyperlipidemia, presented to the emergency room with complaints of altered mentation. Per husband, she was having episodes of emesis and diarrhea 3 days prior to admission that resolved however, her mentation significantly deteriorated to where she was unable to perform simple chores around the house. Pertinently she had resection of lung mass 2 months prior to admission which found to be benign. Vital sign at admission was stable and on examination, the patient was alert and oriented, however, lethargic appearing. Neurological examination was pertinent for expressive aphasia; however, cranial nerves II-XII were grossly intact. The patient was also found to have a 3 cm by 4 cm, tender, cystic lesion on the left-sided occipital scalp. The remainder of the physical examination was unremarkable. Admission laboratories were remarkable for leukocytosis and hyperglycemia. MRI of the brain was completed that showed multiple areas of vasogenic edema and multiple nodules with the largest being 1.8 cm suggestive of abscesses. She was started empirically on vancomycin, ceftriaxone, metronidazole, and ampicillin. Cerebral spinal fluid showed neutrophilic pleocytosis, low glucose, and high protein. Initial cultures including CSF were negative. Left-sided occipital scalp lesion was excised and sent for pathology and culture. Initial cultures showed gram-positive bacilli, so antibiotics were de-escalated to sulfamethoxazole/trimethoprim and ceftriaxone. Repeat imaging showed improving abscess, and final cultures resulted in NB. Conclusion NB is believed to have originated in Southeast Asia. NB has been associated mainly with infections in immunocompromised. In the United States, the two only other cases of NB described in immunocompetent hosts were interestingly from Florida as well. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Pathway in the Treatment of Nocardial Brain Abscesses following Systemic Infections

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Yun-Cong Zheng ◽  
Tse-Lun Wang ◽  
Jee-Ching Hsu ◽  
Yung-Hsing Hsu ◽  
Wen-Hsing Hsu ◽  
...  
Keyword(s):  
Medical Center ◽  
Immunosuppressive Agents ◽  
Cerebral Lesions ◽  
Neurological Outcomes ◽  
Immunocompromised Status ◽  
Brain Abscesses ◽  
Cerebral Nocardiosis ◽  
Immunocompromised State ◽  
Systemic Infections ◽  
Immunocompromised Hosts

Nocardial infections are commonly encountered in patients with immunocompromised states. Cerebral nocardiosis is an uncommon clinical entity, representing only 2% of all cerebral abscesses. It has a higher mortality rate, especially for multiple cerebral lesions in immunocompromised hosts following systemic infections. However, an optimal treatment policy to deal with these immunocompromised patients in Asia is still lacking. We retrospectively reviewed the subjects with nocardial brain abscesses from 2001 to 2011 at our medical center. All of them had multiple brain abscesses, underlying with immunocompromised state following systemic infections. All cases were under steroid control due to their comorbidities for more than six months. The comorbidities and misdiagnosis often lead to poor prognosis. The change in the environments of the microorganisms caused by immunosuppressive agents and multiple antibiotic uses may play an important role in this critical disorder. Aggressive craniotomy should be performed in time to avoid grievous neurological outcomes. Our conclusion is that early diagnosis and appropriate antibiotic uses should be implemented promptly, and aggressive craniotomy should be performed for nocardial brain abscesses in subjects with systemic infections under an immunocompromised status.

Influence of Cell Wall Composition on the Fossilisation of Bacteria and the Implications for the Search for Early Life Forms

1997 ◽  
Vol 161 ◽  
pp. 491-504 ◽  
Author(s):  
Frances Westall
Keyword(s):  
Cell Wall ◽  
Life Forms ◽  
Cation Binding ◽  
Positive Bacterium ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Transmission Electron ◽  
Hydrothermal Sediments ◽  
Identification Of Bacteria ◽  
The Difference

AbstractThe oldest cell-like structures on Earth are preserved in silicified lagoonal, shallow sea or hydrothermal sediments, such as some Archean formations in Western Australia and South Africa. Previous studies concentrated on the search for organic fossils in Archean rocks. Observations of silicified bacteria (as silica minerals) are scarce for both the Precambrian and the Phanerozoic, but reports of mineral bacteria finds, in general, are increasing. The problems associated with the identification of authentic fossil bacteria and, if possible, closer identification of bacteria type can, in part, be overcome by experimental fossilisation studies. These have shown that not all bacteria fossilise in the same way and, indeed, some seem to be very resistent to fossilisation. This paper deals with a transmission electron microscope investigation of the silicification of four species of bacteria commonly found in the environment. The Gram positiveBacillus laterosporusand its spore produced a robust, durable crust upon silicification, whereas the Gram negativePseudomonas fluorescens, Ps. vesicularis, andPs. acidovoranspresented delicately preserved walls. The greater amount of peptidoglycan, containing abundant metal cation binding sites, in the cell wall of the Gram positive bacterium, probably accounts for the difference in the mode of fossilisation. The Gram positive bacteria are, therefore, probably most likely to be preserved in the terrestrial and extraterrestrial rock record.

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