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A Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient

  • Kim, Jinyoung (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kang, Minkyu (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kim, Juri (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Jung, Sohee (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Park, Junhung (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Lee, Dongkyu (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Yoon, Heejung (Department of Infectious Diseases, Seoul Metropolitan Government Seobuk Hospital)
  • 투고 : 2014.08.03
  • 심사 : 2015.07.01
  • 발행 : 2016.03.31

초록

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

키워드

참고문헌

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피인용 문헌

  1. Cloning, Expression, Invasion, and Immunological Reactivity of a Mammalian Cell Entry Protein Encoded by the mce1 Operon of Nocardia farcinica vol.8, pp.None, 2017, https://doi.org/10.3389/fmicb.2017.00281
  2. Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer : A case report and literature review vol.96, pp.13, 2016, https://doi.org/10.1097/md.0000000000006526
  3. Isolated Nocardiosis, an Unrecognized Primary Immunodeficiency? vol.11, pp.None, 2016, https://doi.org/10.3389/fimmu.2020.590239