Lung and Cerebral Nocardiosis Caused by Nocardia elegans in a Lung Transplant Recipient: A Case Report and Literature Review

Keitaro Omori; Hiroki Kitagawa; Rie Nagaoka; Yasuhiko Naka; Kazuma Kawamoto; Yasushi Horimasu; Toshihito Nomura; Norifumi Shigemoto; Takashi Yaguchi; Noboru Hattori; Hiroki Ohge

doi:10.2169/internalmedicine.9813-22

CASE REPORTS

Lung and Cerebral Nocardiosis Caused by Nocardia elegans in a Lung Transplant Recipient: A Case Report and Literature Review

Keitaro Omori, Hiroki Kitagawa, Rie Nagaoka, Yasuhiko Naka, Kazuma Kawamoto, Yasushi Horimasu, Toshihito Nomura, Norifumi Shigemoto, Takashi Yaguchi, Noboru Hattori, Hiroki Ohge

Author information

Keitaro Omori
Department of Infectious Diseases, Hiroshima University Hospital, Japan
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Hiroki Kitagawa
Department of Infectious Diseases, Hiroshima University Hospital, Japan
Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Rie Nagaoka
Section of Clinical Laboratory, Department of Clinical Support, Hiroshima University Hospital, Japan
Division of Clinical Laboratory Medicine, Hiroshima University Hospital, Japan
Yasuhiko Naka
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Kazuma Kawamoto
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Yasushi Horimasu
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Toshihito Nomura
Department of Infectious Diseases, Hiroshima University Hospital, Japan
Norifumi Shigemoto
Department of Infectious Diseases, Hiroshima University Hospital, Japan
Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Translational Research Center, Hiroshima University, Japan
Takashi Yaguchi
Medical Mycology Research Center, Chiba University, Japan
Noboru Hattori
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
Hiroki Ohge
Department of Infectious Diseases, Hiroshima University Hospital, Japan

Keywords: lung and cerebral nocardiosis, Nocardia elegans, lung transplant, mass spectrometry, brain abscess

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 3 Pages 431-437

DOI https://doi.org/10.2169/internalmedicine.9813-22

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Abstract

Patients after lung transplantation are at risk for Nocardia infections. We herein report a case of lung and cerebral nocardiosis caused by Nocardia elegans, a rare species of Nocardia, in a lung transplant recipient. Antibiotic therapy, including sulfamethoxazole-trimethoprim (ST), and brain abscess drainage improved symptoms and imaging findings. A literature review of N. elegans infections showed that 12 of 14 cases (85.7%) were reported from East Asia, particularly Japan (9 cases, 64.2%). The lungs were the predominant site (12/14 cases, 85.7%), and most of the cases were susceptible to ST (9/10 cases, 90%).

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