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Nocardiosis in a tertiary care hospital in North India and review of patients reported from India

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Abstract

Nocardiosis, an uncommon infection of the past, is being increasingly reported in recent years with rise of immunosuppressed patients. In India, very few centers have reported this disease. The present report describes twelve consecutive cases of nocardiosis reported over a period of 26 months (January 2004 to March 2006) from a tertiary care center in north India. The patients were predominantly males (75%) with age range of 8–65 years and mean age of 38.4 years. Eleven patients had known underlying illness including renal transplantation, human immunodeficiency virus infection, and long-term steroid therapy. One patient with cerebral nocardiosis had no detectable predisposing factor. Infection involved central nervous system (3 cases), lungs (5 cases), subcutaneous tissue (1 case), and anterior mediastinum (1 case). Disseminated infection was documented in two patients. Nocardia asteroides complex was incriminated in six patients, N. brasiliensis in five and N. otitidiscaviarum in one patient. All the isolates were sensitive to co-trimoxazole, amikacin, cefotaxime and imipenem. Good therapeutic response was observed in 10 (90.9%) of 11 patients treated with antibiotics including co-trimaxazole, cephalosporins, amikacin, and imipenem alone or in combination. The series of nocardiosis reported from India has also been reviewed.

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References

  1. Beaman BL, Burnside J, Edwards B, Causey W. Nocardial infections in United States, 1972–1974. J Infect Dis 1976;134:286–9.

    PubMed  CAS  Google Scholar 

  2. Randhawa HS, Mishra SK, Sandhu RS, Muzumdar PR, Jain RC, Rao PU, Prakash D, Vishwanathan R, Subramanian S, Sharma VN, Damodaran VN. Prevalence of nocardiosis in bronchopulmonary diseases. Indian J Med Res 1973;61:689–99.

    PubMed  CAS  Google Scholar 

  3. Gaude GS, Hemashettar BM, Bagga AS, Chatterji R. Clinical profile of pulmonary nocardiosis. Indian J Chest Dis Allied Sci 1999;41:153–7.

    PubMed  CAS  Google Scholar 

  4. John GT, Shankar V, Abraham AM, Mathews MS, Thomas JP, Jacob CK. Nocardiosis in tropical renal transplant recipients. Clin Transplant 2002;16:285–9.

    Article  PubMed  Google Scholar 

  5. Verghese S, Madhavan HN, Sekar B. Isolation and characteristics of Nocardia from clinical specimens. J Indian Med Assoc 1996;94:58–5.

    PubMed  CAS  Google Scholar 

  6. Singh M, Sandhu RS, Randahawa HS, Kallan BM. Prevalence of pulmonary nocardiosis in a tuberculosis hospital in Amritsar, Punjab. Indian J Chest Dis Allied Sci 2000;42:325–39.

    PubMed  CAS  Google Scholar 

  7. Talwar P, Chakrabarti A, Ayyagiri A,Nayak N, Khosla VK, Minz M, Yadav RVS. Brain abscess due to Nocardia. Mycopathologia 1989;108:21–3.

    Article  PubMed  CAS  Google Scholar 

  8. Shome SK, Upreti HB, Singh MM, Pamra SP. Mycoses associated with pulmonary tuberculosis. Indian J Tub 1976;23:64–8.

    Google Scholar 

  9. Ragahavan R, Date A, Baktaviziam A. Systemic fungal and Nocardial infections in a tropical environment. Trans Royal Soc Trop Med Hyg 1987;81:476–7.

    Article  Google Scholar 

  10. Gupta ML, Grover PS, Bharadwaj BK. Nocardia associated with pulmonary tuberculosis. J Com Dis 1991;23:157–9.

    CAS  Google Scholar 

  11. Tendolkar U, Deodhar L, Khatri M. Prevalence of Nocardiosis and use of modified Thayer-Martin medium. Indian J Pathol Microbiol 1994;37:395–401.

    PubMed  CAS  Google Scholar 

  12. Verghese S, Kurain VM, Maria CF, Padmaja P, Elizabath ST, Cherian KM. Nocardia asteroids mediastinitis complicating coronary artery by pass surgery. J Assoc Physicians India 2003;51:1009–10.

    PubMed  Google Scholar 

  13. Gowrinath K, Das S, Ranjitham M, Shekar U, Thanasekaran V. Nocardial hydropneumothorax. Indian J Chest Allied Sci 2004;46:51–3.

    Google Scholar 

  14. Das S. Cutaneous nocardiosis in East Delhi: a case report. Indian J Med Sci 2001;55:337–9.

    PubMed  CAS  Google Scholar 

  15. Manikandan P, Bhaskar M, Revathi R, Anitha R, Abarna Lakshmi LR, Narandran V. Isolation and antimicrobial susceptibility pattern of Nocardia among people with culture proven ocular infections attending a tertiary care hospital in tamilnadu, South India. Eye 2006;6:1–7 (Epub ahead of print).

    Google Scholar 

  16. John GT, Shankar V, Talaulikar G, Mathews MS, Abraham MA, Thomas PP, Jacob CK. Epidemiology of systemic mycoses among renal transplant recipients in India. Transplantation 2003;75:1544–51.

    Article  Google Scholar 

  17. Subhash HS, Christopher DJ, Roy A, Cherian AM. Pulmonary nocardiosis in human immunodeficiency virus infection: a tuberculosis mimic. J Postgraduate Med 2001;47:30–2.

    CAS  Google Scholar 

  18. Jha R, Narayanb G, Jaleel MA, Sinha S, Bhaskar V, Kashyap G, Rayadu BR, Prasad KN. Pulmonary infections after kidney transplantation. J Assoc Physician India 1999;47:779–83.

    CAS  Google Scholar 

  19. Singh M, Kallan BM, Sandhu RS. Occurrence of pulmonary nocardiosis in Amritsar. Indian J Chest Allied Sci. 1982;24:1–6.

    Google Scholar 

  20. McNeil MM, Brown JM. The medically important aerobic Actinomycetes: Epidemiology and microbiology. Clin Microbiol Rev 1994;7:357–417.

    PubMed  CAS  Google Scholar 

  21. Brown JM, Mc Neill MM., Nocardia, Rhodococcus, Gordonia, Actinomadura, Streptomyces and other Aerobic Actinomycetes. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolkman RH, editors. Manual of clinical microbiology.Washington DC: ASM Press; 2003. p. 502–531.

    Google Scholar 

  22. Gombert ME. Susceptibility of N. asteroids to various antibiotics, including newer b-Lactums, trimethoprim- sulfamethoxole, amikacin and N-formimidoxyl thienamycin. Antimicrob Agents Chemother 1982;21:1011–2.

    PubMed  CAS  Google Scholar 

  23. Goel S, Kanta S. Prevalence of Nocardia species in the soil of Patiala area. Indian J Pathol Microbiol 1993;36:53–60.

    PubMed  CAS  Google Scholar 

  24. Randhawa HS, Khan ZU. Pulmonary and systemic nocardiosis. Indian J Chest Dis 1977;19:32–44.

    CAS  Google Scholar 

  25. Wilson JP, Helen R, Turner MD, Kirchner KA, Chapman SW. Nocardial infections in renal transplant recipients. Medicine 1989;68:38–56.

    Article  PubMed  CAS  Google Scholar 

  26. Nampoory MRN, Khan ZU, Johny KV, Nessim J, Gupta RK, AL-Muzairai I, Samhan M, Chug TD. Nocardiosis in renal transplant recipients in Kuwait. Nephrol Dial Transplant 1996;11:1134–8.

    PubMed  CAS  Google Scholar 

  27. Lederman ER, Crum NF. A case series and focused review of nocardiosis. Medicine 2004;83:300–33.

    Article  PubMed  Google Scholar 

  28. Uttamchandini RB, Daikos GL, Reyes RR, Fischi MA, Dickinson GM, Yamaguchi E, Kramer MR. Nocardiosis in 30 patients with advanced HIV infection: Clinical features and outcome. Clin Infect Dis 1994;18:348–53.

    Google Scholar 

  29. Thaler F, Gotainers B, Teodori G, Dubois C, Loirat P. Mediastinitis due to Nocardia asteroids after cardiac transplantation. Intensive care Med 1992;18:1278.

    Article  Google Scholar 

  30. Pitchenik AE, Zaunbrecher F. Super vena cava syndrome caused by Nocardia asteroids. Am Rev Respr Dis 1978;117:795–8.

    CAS  Google Scholar 

  31. Mootsikapun P, Intarapoka B, Laiwnoraset W. Nocardiosis in Srinagarid hospital, Thailand; review of 70 cases from 1996–2001. Int J Infect Dis 2005; 9:154–8.

    Google Scholar 

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Correspondence to Arunaloke Chakrabarti.

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Shivaprakash, M.R., Rao, P., Mandal, J. et al. Nocardiosis in a tertiary care hospital in North India and review of patients reported from India. Mycopathologia 163, 267–274 (2007). https://doi.org/10.1007/s11046-007-9011-1

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