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Abstract

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Article in Japanese

Case Report

Disseminated nocardiosis resulting from Nocardia otitidiscaviarum with multiple pulmonary nodules

Chie Yasudaa  Kazufumi Hiramatsua  Takehiro Hashimotoa  Hiroki Yoshikawaa  Issei Tokimatsub,  Jun-ichi Kadotaa 

aDepartment of Respiratory Medicine and Infectious Disease, Oita University Faculty of Medicine
bDepartment of Infection Prevention and Control, Kobe University Hospital Health and Medicine

ABSTRACT

We report a case of multiple pulmonary nodules in an 80-year-old man with adult Still's disease who was receiving corticosteroid treatment. Microbiological examination of sputum was positive for Nocardia, and pulmonary nocardiosis was diagnosed. He was treated with oral sulfamethoxazole-trimethoprim alone; however, his cavitary pulmonary nodules were worsened. Brain magnetic resonance imaging showed small high-intensity nodules, and disseminated nocardiosis was diagnosed based on sputum, skin cultures growing Nocardia sp. After he was treated with amikacin and imipenem/cilastatin, pulmonary and brain nodules were improved. The isolate was later identified as Nocardia otitidiscaviarum by 16S rRNA analysis. Pulmonary nocardiosis resulting from N. otitidiscaviarum appears to be rare, and isolated N. otitidiscaviarum showed resistance to antimicrobial agents, including sulfamethoxazole-trimethoprim and imipenem. Disseminated nocardiosis, including central nervous system infection, is a poor prognosis, and multiple antimicrobial therapy should be important until isolates identify antimicrobial susceptibility.

KEYWORDS

Nocardia otitidiscaviarum  Disseminated nocardiasis  Corticosteroid  Multiple pulmonary nodules 

Received 28 Apr 2016 / Accepted 10 Nov 2016

AJRS, 6(2): 84-88, 2017

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