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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
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[Vol.35 No.3 contents] Japanese / English |
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| ArticleTitle | A case of infective endocarditis and disseminated infection due to Nocardia pulmonis |
| Language | J |
| AuthorList | Ryoya Takano1), Maho Kimoto1), Tomomi Amano1), Natsuko Matsui1), Ayako Iwata1), Takeshi Ohshima1), Shoko Sahara2), Hitoshi Kuramae2), Atsushi Torii3), Misaki Uchida3), Masahiro Kusaka3), Naoya Takeda3), Akira Watanabe4), Masahiro Takekoshi5), Keisuke Oka6) |
| Affiliation |
1) Department of Clinical Laboratory Pathology, Kariya Toyota General Hospital 2) Safety Environment Management Office, Kariya Toyota General Hospital 3) Department of Respiratory Medicine, Kariya Toyota General Hospital 4) Department of Clinical Research, Medical Mycology Research Center, Chiba University 5) Department of Clinical Laboratory Pathology, Nagoya University Hospital 6) Department of Infectious Diseases, Nagoya University Hospital |
| Publication | J.J.C.M.: 35 (3), 230-236, 2025 |
| Received | January 8, 2025 |
| Accepted | April 30, 2025 |
| Abstract | We report a rare case of disseminated infection with infective endocarditis caused by Nocardia pulmonis in an immunocompromised patient in his seventies. He presented with fever and dyspnea. The patient had a medical history of interstitial pneumonia and ANCA-associated vasculitis, for which he was receiving corticosteroid therapy. Filamentous Gram-positive bacilli were isolated from one aerobic bottle of blood culture and bronchoalveolar lavage fluid, and positive Kinyoun staining suggested infection with Nocardia species. Initial therapy with trimethoprim-sulfamethoxazole and imipenem/cilastatin was initiated, targeting Nocardia farcinica. However, 16S rRNA gene sequencing analysis identified the organism as N. pulmonis, a species newly registered in 2023, which was found to be resistant to the initial regimen. Antimicrobial therapy was subsequently changed to amikacin and minocycline. Echocardiography revealed vegetations on the aortic valve, leading to a diagnosis of infective endocarditis. The patient's condition deteriorated following a COVID-19 infection during hospitalization, and he subsequently passed away. This case report contributes to our understanding of the microbiological characteristics and clinical manifestations of N. pulmonis. |
| Keywords | Nocardia pulmonis |
| Copyright © 2002 The Japanese Society for Clinical Microbiology All rights reserved. |