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.
ObjectiveTo describe the clinical characteristics of pulmonary nocardiosis associated with bronchiectasis and to evaluate the methods of diagnosis and treatment.MethodsClinical data of two patients with pulmonary nocardiosis and bronchiectasis were analyzed and the literature on the subject were reviewed.ResultsTwo female patients with bronchiectasis were respectively 55 and 62 years old, both of them presented with fever, cough, expectoration, and leukocytosis. Case 1 also complicated with respiratory failure and leukemoid reaction. Chest CT showed bilateral pulmonary multi-patchy consolidations with cavities in case 1 and unilateral pulmonary local consolidation without cavities in case 2. Sputum smears on modified Ziehl-Neelsen staining of both patients showed typical Nocardia hyphe. Sputum culture of case 1 showed Nocardia otitidiscaviarum, which was sensitive to sulfamethoxazole/trimethoprim (SMZ/TMP), amikacin and moxifloxacin while resistant to ceftriaxone, imipenem and meropenem. Sputum culture of case 2 was negative. Case 1 was treated with SMZ/TMP + moxifloxacin + amikacin for 6 months, and case 2 treated with SMZ/TMP for 3 months. Both patients were clinically cured. Six case reports including 7 patients were searched, including 4 Chinese reports and 2 English reports. Most of them were reported individually. ConclusionsBronchiectasis is a risk factor for pulmonary nocardiosis, and the treatment of nocardiosis should accord with drug susceptibilities and severities of diseases. The prognoses of patients with pulmonary nocardiosis and bronchiectasis are relatively good.