Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

Santoro Carmen Rita; Brindicci Gaetano; Mazzola Michele; Giannelli Anna; Infante Giovanni; Fiorella Carmen Silvia; Pappalettera Antonio; Capodivento Saverio; Cascarano Marina; Quinto Nicola; Losappio Ruggero; Laura Monno

doi:doi:10.11648/j.ijidt.20180303.13

Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report

Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, Fiorella Carmen Silvia, Pappalettera Antonio, Capodivento Saverio, Cascarano Marina, Quinto Nicola, Losappio Ruggero, Laura Monno

Published in International Journal of Infectious Diseases and Therapy (Volume 3, Issue 3)

Received: 3 August 2018 Accepted: 12 September 2018 Published: 25 October 2018

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Abstract

The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.

Published in	International Journal of Infectious Diseases and Therapy (Volume 3, Issue 3)
DOI	10.11648/j.ijidt.20180303.13
Page(s)	62-65
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Disseminated Nocardiosis, AIDS, Late Advanced Naive

References

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[2]	Conville P.S., Brown-Elliott B.A., Smith T., Zelazny A.M. The Complexities of Nocardia Taxonomy and Identification. J Clin Microbiol. 56(1), 2017.
[3]	Brown-Elliott B.A., Brown J.M., Conville P.S. and Wallace R.J. Jr. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 19: 259-282, 2006.
[4]	Corti M.E., Villafafie Fioti M.F. Nocardiosis: a review. Int J Infect Dis 7: 243-250, 2003.
[5]	Wilson J.W. Nocardiosis: Updates and Clinical Overview. Mayo Clin Proc. 87(4):403-407, 2012.
[6]	Yu S., Wang J., Fang Q., Zhang J., Yan F. Specific clinical manifestations of Nocardia: A case report and literature review. Exp Ther Med. 12(4): 2021–2026, 2016.
[7]	Peleg A.Y., Husain S., Qureshi Z.A. et al. Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study. Clin Infect Dis. 44:1307–1314, 2007.
[8]	Kim Y.K., Sung H., Jung J. et al. Impact of immune status on the clinical characteristics and treatment outcomes of nocardiosis. Diagn Microbiol Infect Di. 85(4):482-7, 2016.
[9]	Senard O. Blanot S. Jouvion G. et al. Fulminant Nocardiosis Due to a Multidrug-Resistant Isolate in a 12-Year-Old Immunocompetent Child. Pediatrics. 141(2). pii: e20163131. doi: 10.1542/peds.2016-3131, 2018.
[10]	Cooper C.J., Said S., Popp M. et al. A complicated case of an immunocompetent patient with disseminated nocardiosis. Infect Dis Rep. 6(1):5327, 2014.
[11]	Valdezate S., Garrido N., Carrasco G. et al. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain. J Antimicrob Chemother. 72(3):754-761, 2017.
[12]	Haussaire D., Fournier P.E., Djiguiba K. et al. Nocardiosis in the south of France over a 10-years period, 2004-2014. Int J Infect Dis. 57:13-20, 2017.
[13]	King A.S., Castro J.G., Dow G.C. Nocardia farcinica lung abscess presenting in the context of advanced HIV infection: spontaneous resolution in response to highly active antiretroviral therapy alone. Can J Infect Dis Med Microbiol. 20:103–106, 2009.
[14]	Palmer D.L., Harvey R.L., Wheeler J.K. Diagnostic and therapeutic considerations in Nocardia asteroids infection. Medicine (Baltimore). 53:391-401, 1974.
[15]	Lucas S.B., Hounnou A., Peacock C., Beaumel A., Kadio A., De Cock K.M. Nocardiosis in HIV-positive patients: an autopsy study in West Africa. Tuber Lung Dis. 75:301-307, 1994.

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APA Style

Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, et al. (2018). Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. International Journal of Infectious Diseases and Therapy, 3(3), 62-65. https://doi.org/10.11648/j.ijidt.20180303.13

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ACS Style

Santoro Carmen Rita; Brindicci Gaetano; Mazzola Michele; Giannelli Anna; Infante Giovanni, et al. Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. Int. J. Infect. Dis. Ther. 2018, 3(3), 62-65. doi: 10.11648/j.ijidt.20180303.13

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AMA Style

Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, et al. Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. Int J Infect Dis Ther. 2018;3(3):62-65. doi: 10.11648/j.ijidt.20180303.13

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@article{10.11648/j.ijidt.20180303.13,
  author = {Santoro Carmen Rita and Brindicci Gaetano and Mazzola Michele and Giannelli Anna and Infante Giovanni and Fiorella Carmen Silvia and Pappalettera Antonio and Capodivento Saverio and Cascarano Marina and Quinto Nicola and Losappio Ruggero and Laura Monno},
  title = {Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {3},
  number = {3},
  pages = {62-65},
  doi = {10.11648/j.ijidt.20180303.13},
  url = {https://doi.org/10.11648/j.ijidt.20180303.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20180303.13},
  abstract = {The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.},
 year = {2018}
}

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TY  - JOUR
T1  - Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report
AU  - Santoro Carmen Rita
AU  - Brindicci Gaetano
AU  - Mazzola Michele
AU  - Giannelli Anna
AU  - Infante Giovanni
AU  - Fiorella Carmen Silvia
AU  - Pappalettera Antonio
AU  - Capodivento Saverio
AU  - Cascarano Marina
AU  - Quinto Nicola
AU  - Losappio Ruggero
AU  - Laura Monno
Y1  - 2018/10/25
PY  - 2018
N1  - https://doi.org/10.11648/j.ijidt.20180303.13
DO  - 10.11648/j.ijidt.20180303.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 62
EP  - 65
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20180303.13
AB  - The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.
VL  - 3
IS  - 3
ER  -

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Author Information

Santoro Carmen Rita

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Brindicci Gaetano

Operative Unit of Infectious Diseases, AOU Consorziale Policlinico, Bari, Italy
Mazzola Michele

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Giannelli Anna

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Infante Giovanni

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Fiorella Carmen Silvia

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Pappalettera Antonio

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Capodivento Saverio

Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Cascarano Marina

Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Quinto Nicola

Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Losappio Ruggero

Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Laura Monno

Operative Unit of Infectious Diseases, AOU Consorziale Policlinico, Bari, Italy

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Plain Text BibTeX RIS

APA Style

Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, et al. (2018). Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. International Journal of Infectious Diseases and Therapy, 3(3), 62-65. https://doi.org/10.11648/j.ijidt.20180303.13

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ACS Style

Santoro Carmen Rita; Brindicci Gaetano; Mazzola Michele; Giannelli Anna; Infante Giovanni, et al. Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. Int. J. Infect. Dis. Ther. 2018, 3(3), 62-65. doi: 10.11648/j.ijidt.20180303.13

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AMA Style

Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, et al. Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report. Int J Infect Dis Ther. 2018;3(3):62-65. doi: 10.11648/j.ijidt.20180303.13

Copy | Download

@article{10.11648/j.ijidt.20180303.13,
  author = {Santoro Carmen Rita and Brindicci Gaetano and Mazzola Michele and Giannelli Anna and Infante Giovanni and Fiorella Carmen Silvia and Pappalettera Antonio and Capodivento Saverio and Cascarano Marina and Quinto Nicola and Losappio Ruggero and Laura Monno},
  title = {Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {3},
  number = {3},
  pages = {62-65},
  doi = {10.11648/j.ijidt.20180303.13},
  url = {https://doi.org/10.11648/j.ijidt.20180303.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20180303.13},
  abstract = {The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.},
 year = {2018}
}

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TY  - JOUR
T1  - Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report
AU  - Santoro Carmen Rita
AU  - Brindicci Gaetano
AU  - Mazzola Michele
AU  - Giannelli Anna
AU  - Infante Giovanni
AU  - Fiorella Carmen Silvia
AU  - Pappalettera Antonio
AU  - Capodivento Saverio
AU  - Cascarano Marina
AU  - Quinto Nicola
AU  - Losappio Ruggero
AU  - Laura Monno
Y1  - 2018/10/25
PY  - 2018
N1  - https://doi.org/10.11648/j.ijidt.20180303.13
DO  - 10.11648/j.ijidt.20180303.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 62
EP  - 65
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20180303.13
AB  - The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.
VL  - 3
IS  - 3
ER  -

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