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. 2023 May 20:53:101148.
doi: 10.1016/j.nmni.2023.101148. eCollection 2023 Jun.

Disseminated Nocardia transvalensis complex and farcinica: First case in an immunocompetent

Abdoulahy Diallo  1 , Yacouba Dembele  2 , Issifou Yaya  3 , Mohamadou Niang  1 , Thierry Benoit-Cattin  4 , Pascal Meliani  1 , Sarah Permal  1
Affiliations

Disseminated Nocardia transvalensis complex and farcinica: First case in an immunocompetent

Abdoulahy Diallo et al. New Microbes New Infect. .

Abstract

Background: Nocardiae is an opportunistic infection mainly of the immunocompromised patient without sparing the immunocompetent subject or without any identified risk factors. They can be localized or disseminated. The extreme rarity of this infection often results in a deleterious diagnostic delay.

Case presentation: We report a first case of community acquired pneumonia with asymptomatic disseminated brain abscess due to Nocardia transvalensis/wallacei and farcinica in an immunocompetent man. The patient fully recovered after receiving optimized antimicrobial therapy.

Conclusions: This case suggests that health care professionals should always evoke this diagnosis when confronted to atypical community-acquired pneumonia, even in immunocompetent patients.

Keywords: Community-acquired pneumonia; Disseminated; Immunocompetent; Nocardia transvalensis; Wallacei and farcinica.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Image 1a
Image 1a
Face chest x-ray: Right hilar and apical alveolar condensation closing an air bronchogram, associated with a bubble of right superior lobe.
Image 1b
Image 1b
Face chest x-ray: Control at 12 months showing a large right apical bubble without sign of secondary infection (star), associated with a cylindrical dilation of the bronchi of the right middle and lower lobes (arrows).
Image 2a
Image 2a
CT scan in sagittal parenchymal window reconstruction: Alveolar condensations taking the right upper lobe with an excavated lesion and an air bronchogram, the lower lobe. Thickening of the septal lines.
Image 3
Image 3
A Gram stain ( × 1000x) of sputum showed branching Gram-positive filaments suggesting a Nocardia infection.
Image 4a
Image 4a
Brain sagittal MRI 3D T1 FFE with gadolinium injection: Left cerebellar contrast enhancement evoking a micro-abscess (arrow) Image 4a which disappears at control at 12 months. Image 4b.
Image 2b
Image 2b
CT scan in sagittal parenchymal window reconstruction: Cystic and cylindrical dilation of the bronchi of the right upper lobe (arrow) with voluminous bubble of sequel emphysema at control at 12 months.
Image 4b
Image 4b
Brain sagittal MRI 3D T1 FFE with gadolinium injection: Left cerebellar contrast enhancement evoking a micro-abscess (arrow) Image 4a which disappears at control at 12 months. Image 4b.
See this image and copyright information in PMC

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