Nocardiosis in the south of France over a 10-years period, 2004-2014

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Haussaire , Delphine ; Fournier , Pierre-Edouard ; Djiguiba , Karamoko ; Moal , Valerie ; Legris , Tristan ; Purgus , Rajsingh ; Bismuth , Jeremy ; Elharrar , Xavier ; Reynaud-Gaubert , Martine ; Vacher-Coponat , Henri (2017)
  • Publisher: Elsevier
  • Journal: International Journal of Infectious Diseases, volume 57, pages 13-20 (issn: 1201-9712, eissn: 1878-3511)
  • Related identifiers: doi: 10.1016/j.ijid.2017.01.005
  • Subject: RC109-216 | Cystic fibrosis | Infectious Diseases | Transplantation | Infectious and parasitic diseases | Nocardiosis | Cancer | [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases | Opportunistic infection | Microbiology (medical)

International audience; Background: Nocardiosis is a rare disease with polymorphic presentations. The epidemiology and clinical presentation could change with the increasing number of immunocompromised patients. Methods: The medical records and microbiological data of patients affected by nocardiosis and treated at the university hospitals of Marseille between 2004 and 2014 were analyzed retrospectively. Results: The cases of 34 patients infected by Nocardia spp during this period were analyzed. The main underlying conditions were transplantation (n = 15), malignancy (n = 9), cystic fibrosis (n = 4), and immune disease (n = 3); no immunodeficiency condition was observed for three patients. No case of AIDS was observed. At diagnosis, 61.8% had received steroids for over 3 months. Four clinical presentations were identified, depending on the underlying condition: the disseminated form (50.0%) and the visceral isolated form (26.5%) in severely immunocompromised patients, the bronchial form (14.7%) in patients with chronic lung disease, and the cutaneous isolated form (8.8%) in immunocompetent patients. Nocardia farcinica was the main species identified (26.5%). Trimethoprim-sulfamethoxazole was prescribed in 68.0% of patients, and 38.0% underwent surgery. Mortality was 11.7%, and the patients who died had disseminated or visceral nocardiosis. Conclusions: The clinical presentation and outcome of nocardiosis depend on the patient's initial immune status and underlying pulmonary condition. Severe forms were all iatrogenic, occurring after treatments altering the immune system. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
  • References (36)
    36 references, page 1 of 4

    1. Provost F, Laurent F, Blanc MV, Boiron P. Transmission of nocardiosis and molecular typing of Nocardia species: a short review. Eur J Epidemiol 1997;13:235-8.

    2. Clark NM, Reid GE. AST Infectious Diseases Community of Practice. Nocardia infections in solid organ transplantation. Am J Transplant 2013;13(Suppl 4):83- 92. doi:

    3. Javaly K, Horowitz HW, Wormser GP. Nocardiosis in patients with human immunodeficiency virus infection: Report of 2 cases and review of the literature. Medicine (Baltimore) 1992;71:128-38.

    4. Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev 1994;7:213-64.

    5. Hui CH, Au VWK, Rowland K, Slavotinek JP, Gordon DL. Pulmonary nocardiosis re-visited: experience of 35 patients at diagnosis. Respir Med 2003;97:709-17.

    6. Farina C, Boiron P, Ferrari I, Provost F, Goglio A. Report of human nocardiosis in Italy between 1993 and 1997. Eur J Epidemiol 2001;17:1019-22.

    7. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 2006;19:259-82. doi: 282.2006.

    8. Bell Melissa, Mc Neil Michael, Brown June M. Nocardia species (nocardiosis)- infectious disease and antimicrobial agents. Epidemiology and Surveillance Division National Immunization Program. Atlanta: Centers for Disease Control and Prevention; 2017

    9. Husain S, McCurry K, Dauber J, Singh N, Kusne S. Nocardia infection in lung transplant recipients. J Heart Lung Transplant 2002;21:354-9.

    10. Mootsikapun P, Intarapoka B, Liawnoraset W. Nocardiosis in Srinagarind Hospital, Thailand: review of 70 cases from 1996-2001. Int J Infect Dis 2005;9:154-8. doi:

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