Case Report

Disseminated Nocardia nova Infection

Authors: Geeta Arora, MD, Mark Friedman, MD, Richard P. MacDermott, MD

Abstract

We report the case of a 61-year-old female with ulcerative colitis on therapy with prednisone and azathioprine. The patient presented with fever, dry cough, a swollen lower extremity, and nodules on the right wrist and the scalp. Computed tomography scans of the head, chest, abdomen, and pelvis revealed multiple lesions. Aspirates and biopsies of the lower extremity cystic lesion, the wrist nodule, and the scalp nodule all grew out Nocardia nova. The patient was treated with high-dose trimethoprim and sulfamethoxazole therapy for one year and made a complete recovery.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Vohra P, Burroughs MH, Houdes DS, et al. Disseminated nocardiosis complicating medical therapy in Crohn's disease. J Pediatr Gastroenterol Nutr 1997;25:233–235.
 
2. Beaman BL, Boiron P, Beaman L, et al. Nocardia and nocardiosis. J Med Vet Mycol 1992;1:317–331.
 
 
3. Peleg AY, Husain S, Qureshi ZA, et al. Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study. Clin Infect Dis 2007;44:1307–1314.
 
4. Larsen H. Aerobic gram-positive bacilli, in Mahon C, Manuselis G (eds): Textbook of Diagnositic Microbiology. Philadelphia, W.B. Sanders Company, 2000, ed 2, pp 396–399.
 
 
5. Brown J, Mcneil M, Desmond E. Nocardia, Rhodococcus, Gordona, Actinomadura, Streptomyces, and other Actinomycetes of medical importance, in Murray P, Baron E, Pfaller M, et al (eds): Manual of Clinical Microbiology. Washington, DC, ASM Press, 1999, ed 7, pp 378–392.
 
 
6. Vassallo J, Galizia AC, Cuschieri P. Mixed pulmonary infection with Nocardia, Candida, methicillin-resistant Staphylococcus aureus, and group D streptococcus species. Postgrad Med J 1996;72:680–681.
 
7. Baldi BG, Santana AN, Takagaki TY. [Pulmonary and cutaneous nocardiosis in a patient treated with corticosteroids]. J Bras Pneumol 2006;32:592–595.
 
 
8. Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev 1994;213–264.
 
 
9. Nizam I, Kohan L, Kerr D. Nocardia nova septic arthritis following total knee replacement: a case report. J Orthop Surg (Hong Kong) 2007;15:390–392.
 
 
10. Burucoa C, Breton I, Ramassamy A, et al. Western blot monitoring of disseminated Nocardia nova infection treated with clarithromycin, imipenum, and surgical drainage. Eur J Clin Microbiol Infect Dis 1996;15:943–947.
 
11. Hamdad F, Vidal B, Douadi Y, et al. Nocardia nova as the causative agent in spondylodiscitis and psoas abscess. J Clin Microbiol 2007;45:262–265.