Pulmonary nocardiosis complicated with aspergillosis: three cases report and literature review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WU Xiaojing , HUANG Xu , FENG Yingying , GU Sichao ,  LI Min

Department of Respiratory and Critical Care Medcine, China-Japan Friendship Hospital, Beijing 100029, P. R. China;

Corresponding author：

LI Min, Email: qlyy_limin@163.com

Keywords：

Pulmonary nocardiosis; Invasive pulmonary aspergillosis; Bronchoalveolar lavage fluid; Immunocompromise

DOI：

10.7507/1671-6205.201707014

Video：

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ObjectiveTo investigate the clinical features of patients who went through Nocardia co-infection with Aspergillus in lung.MethodsClinical data of 3 pulmonary nocardiosis patients complicated with aspergillosis from China-Japan Hospital during June 2015 and May 2016 were retrospectively analyzed. Nine related literatures found at PubMed were reviewed and they all were case report. No Chinese literature was found at Wanfang data and Chinese Journal Fulltext Database.ResultsAll of the 3 patients were diagnosed as pulmonary nocardiosis by etiological detection, at the same time meeting the diagnostic criteria of invasive pulmonary aspergillosis. Two cases were infected with Aspergillus fumigatus. Aspergillus was not detected in the third case, but the galactomannan of serum and bronchoalveolar lavage fluid significantly increased.ConclusionPulmonary nocardiosis complicated with aspergillosis trends to occur in immunocompromised patients, and pathogen detection is important for diagnosis.

Citation： WU Xiaojing, HUANG Xu, FENG Yingying, GU Sichao, LI Min. Pulmonary nocardiosis complicated with aspergillosis: three cases report and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(4): 359-363. doi: 10.7507/1671-6205.201707014 Copy

1.	Abreu C, Rocha-Pereira N, Sarmento A, et al. Nocardia infections among immunomodulated inflammatory bowel disease patients: A review. World J Gastroenterol, 2015, 21(21): 6491-6498.
2.	Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis, 2016, 63(4): e1-e60.
3.	De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis, 2008, 46(12): 1813-1821.
4.	Casale TB, Macher AM, Fauci AS. Concomitant pulmonary aspergillosis and nocardiosis in a patient with chronic granulomatous disease of childhood. South Med J, 1984, 77(2): 274-275.
5.	Carter JM, Green WR, Callender CO, et al. Pulmonary cavitation with Nocardia and Aspergillus in a renal transplant patient. J Natl Med Assoc, 1990, 82(7): 527-528, 530-521.
6.	Monteforte JS, Wood CA. Pneumonia caused by Nocardia nova and Aspergillus fumigatus after cardiac transplantation. Eur J Clin Microbiol Infect Dis, 1993, 12(2): 112-114.
7.	van Dam AP, Pruijm MT, Harinck BI, et al. Pneumonia involving Aspergillus and Rhizopus spp. after a near-drowning incident with subsequent Nocardia cyriacigeorgici and N. farcinica coinfection as a late complication. Eur J Clin Microbiol Infect Dis, 2005, 24(1): 61-64.
8.	Al-Anazi KA, Aljurf MD, Al-Mohareb FI, et al. Successful management of invasive pulmonary nocardiosis and aspergillosis in a patient with T-cell lymphoma: a case report. Clin Med Case Rep, 2008, 1: 65-71.
9.	Hamadani M, Benson DM, Jr., Blum W, et al. Pulmonary Nocardia and Aspergillus co-infection in a patient with chronic graft-versus-host disease. Transpl Infect Dis, 2008, 10(1): 24-26.
10.	Cabada MM, Nishi SP, Lea AS, et al. Concomitant pulmonary infection with Nocardia transvalensis and Aspergillus ustus in lung transplantation. J Heart Lung Transplant, 2010, 29(8): 900-903.
11.	Misra DP, Parida JR, Chowdhury AC, et al. Pulmonary co-infection with Nocardia and Aspergillus in a patient with adult-onset Still's disease receiving steroids and tacrolimus. BMJ Case Rep, 2014, 2014.
12.	Sharma B, Ghosh G, Kamble U, et al. Allergic broncho pulmonary aspergillosis complicated by nocardiosis. Case Rep Pulmonol, 2012, 2012: 758630.
13.	Mehrian P, Esfandiari E, Karimi MA, et al. Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients. Pol J Radiol, 2015, 80: 13-17.
14.	Castellana G, Grimaldi A, Castellana M, et al. Pulmonary nocardiosis in chronic obstructive pulmonary aisease: a new clinical challenge. Respir Med Case Rep, 2016, 18: 14-21.
15.	Kandi V. Human Nocardia infections: a review of pulmonary nocardiosis. Cureus, 2015, 7(8): e304.
16.	Canterino J, Paniz-Mondolfi A, Brown-Elliott BA, et al. Nocardia thailandica pulmonary nocardiosis in a post-solid organ transplant patient. J Clin Microbiol, 2015, 53(11): 3686-3690.
17.	Kurahara Y, Tachibana K, Tsuyuguchi K, et al. Pulmonary nocardiosis: a clinical analysis of 59 cases. Respir Investig, 2014, 52(3): 160-166.
18.	Tsujimoto N, Saraya T, Kikuchi K, et al. High-resolution CT findings of patients with pulmonary nocardiosis. J Thorac Dis, 2012, 4(6): 577-582.
19.	Simpson RS RR. Nocardiosis and actinomycosis. Medicine, 2014, 42: 23-25.
20.	吴小静, 顾思超, 李敏, 等. 肺诺卡菌病六例临床分析. 中华临床感染病杂志, 2017, 10(4): 274-277.

1. Abreu C, Rocha-Pereira N, Sarmento A, et al. Nocardia infections among immunomodulated inflammatory bowel disease patients: A review. World J Gastroenterol, 2015, 21(21): 6491-6498.
2. Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis, 2016, 63(4): e1-e60.
3. De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis, 2008, 46(12): 1813-1821.
4. Casale TB, Macher AM, Fauci AS. Concomitant pulmonary aspergillosis and nocardiosis in a patient with chronic granulomatous disease of childhood. South Med J, 1984, 77(2): 274-275.
5. Carter JM, Green WR, Callender CO, et al. Pulmonary cavitation with Nocardia and Aspergillus in a renal transplant patient. J Natl Med Assoc, 1990, 82(7): 527-528, 530-521.
6. Monteforte JS, Wood CA. Pneumonia caused by Nocardia nova and Aspergillus fumigatus after cardiac transplantation. Eur J Clin Microbiol Infect Dis, 1993, 12(2): 112-114.
7. van Dam AP, Pruijm MT, Harinck BI, et al. Pneumonia involving Aspergillus and Rhizopus spp. after a near-drowning incident with subsequent Nocardia cyriacigeorgici and N. farcinica coinfection as a late complication. Eur J Clin Microbiol Infect Dis, 2005, 24(1): 61-64.
8. Al-Anazi KA, Aljurf MD, Al-Mohareb FI, et al. Successful management of invasive pulmonary nocardiosis and aspergillosis in a patient with T-cell lymphoma: a case report. Clin Med Case Rep, 2008, 1: 65-71.
9. Hamadani M, Benson DM, Jr., Blum W, et al. Pulmonary Nocardia and Aspergillus co-infection in a patient with chronic graft-versus-host disease. Transpl Infect Dis, 2008, 10(1): 24-26.
10. Cabada MM, Nishi SP, Lea AS, et al. Concomitant pulmonary infection with Nocardia transvalensis and Aspergillus ustus in lung transplantation. J Heart Lung Transplant, 2010, 29(8): 900-903.
11. Misra DP, Parida JR, Chowdhury AC, et al. Pulmonary co-infection with Nocardia and Aspergillus in a patient with adult-onset Still's disease receiving steroids and tacrolimus. BMJ Case Rep, 2014, 2014.
12. Sharma B, Ghosh G, Kamble U, et al. Allergic broncho pulmonary aspergillosis complicated by nocardiosis. Case Rep Pulmonol, 2012, 2012: 758630.
13. Mehrian P, Esfandiari E, Karimi MA, et al. Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients. Pol J Radiol, 2015, 80: 13-17.
14. Castellana G, Grimaldi A, Castellana M, et al. Pulmonary nocardiosis in chronic obstructive pulmonary aisease: a new clinical challenge. Respir Med Case Rep, 2016, 18: 14-21.
15. Kandi V. Human Nocardia infections: a review of pulmonary nocardiosis. Cureus, 2015, 7(8): e304.
16. Canterino J, Paniz-Mondolfi A, Brown-Elliott BA, et al. Nocardia thailandica pulmonary nocardiosis in a post-solid organ transplant patient. J Clin Microbiol, 2015, 53(11): 3686-3690.
17. Kurahara Y, Tachibana K, Tsuyuguchi K, et al. Pulmonary nocardiosis: a clinical analysis of 59 cases. Respir Investig, 2014, 52(3): 160-166.
18. Tsujimoto N, Saraya T, Kikuchi K, et al. High-resolution CT findings of patients with pulmonary nocardiosis. J Thorac Dis, 2012, 4(6): 577-582.
19. Simpson RS RR. Nocardiosis and actinomycosis. Medicine, 2014, 42: 23-25.
20. 吴小静, 顾思超, 李敏, 等. 肺诺卡菌病六例临床分析. 中华临床感染病杂志, 2017, 10(4): 274-277.

Chinese Journal of Respiratory and Critical Care Medicine

Pulmonary nocardiosis complicated with aspergillosis: three cases report and literature review

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