Retroperitoneal abscesses due to Nocardia farcinica: Report of two cases in patients with malnutrition

Service de Médecine Interne, AP-HP, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92118, Clichy, France.
Infection (Impact Factor: 2.62). 08/2011; 40(1):93-6. DOI: 10.1007/s15010-011-0176-7
Source: PubMed
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    ABSTRACT: Nocardia farcinica is a rare Nocardia species causing localised and disseminated infections. A case of Nocardia farcinica infection is presented, and 52 cases previously reported in the literature are reviewed. The hosts usually had predisposing conditions (85%), and acquired the infection through the respiratory tract or skin; the infection then often spread to the brain, kidney, joints, bones and eyes. Pulmonary or pleural infections (43%), brain abscesses (30%) and wound infections (15%) which failed to respond to conventional antimicrobial therapy were the more frequent forms of infection. Nocardia farcinica was frequently isolated from pus (100% of samples), bronchial secretions (41%) and biopsy specimens (63%), but isolation from blood and urine, as in the case presented here, is rare. Antibiotic therapy was adequate in 61% of the patients in whom it was specified, the agents most frequently given being trimethoprim-sulfamethoxazole (54%), amikacin combined with imipenem (7%) and amoxicillin-clavulanate (7%). The high mortality (31%) can be attributed to the severe underlying diseases present, difficulties encountered in identifying the pathogen, inappropriate therapy and late initiation of therapy. Although an infrequent pathogen, Nocardia farcinica should be kept in mind as a cause of infection especially in immunosuppressed patients with indolent infections not responding to third-generation cephalosporins.
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    ABSTRACT: The in vitro activities of tigecycline and other antimicrobials against 51 isolates of Nocardia spp. were evaluated. MIC(90)s and MIC ranges were as follows: tigecycline, 4 and < or =0.06 to 8 mg/liter, respectively; minocycline, 2 and < or =0.06 to 2 mg/liter, respectively; linezolid, 1 and < or =0.06 to 2 mg/liter, respectively; moxifloxacin, 2 and < or =0.06 to >64 mg/liter, respectively; ertapenem, 32 and < or =0.06->64 mg/liter, respectively; imipenem, 2 and < or =0.06 to >64 mg/liter, respectively; meropenem, 8 and < or =0.06 to >64 mg/liter, respectively; amikacin, 1 and < or =0.06 to 32 mg/liter, respectively; and trimethoprim-sulfamethoxazole, 1/19 and < or =0.5/9.5 to >2/38 mg/liter, respectively.
    Antimicrobial Agents and Chemotherapy 04/2007; 51(3):1102-4. DOI:10.1128/AAC.01102-06 · 4.48 Impact Factor
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    ABSTRACT: Central venous catheter-associated Nocardia bacteremia is rarely reported. We present the case of a 48-y-old male with a history of advanced T-cell lymphoma who suffered from recurrent fever and persistent Gram-positive bacillus bacteremia. Port-A catheter-associated Nocardia bacteremia was diagnosed on the basis of the clinical response to removal of the catheter and the finding of increased gallium uptake, along with the Port-A catheter presented in the gallium inflammation scan.
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