Pulmonary nocardiosis caused by Nocardia blacklokiae in an immunocompetent patient

Yuhei Ito; Motoaki Tanigawa; Takashi Yaguchi; Hirokazu Toyoshima; Keisuke Iwamoto; Akina Nigi; Hidetoshi Itani; Shigeto Kondo; Toshiya Tokui; Hajime Sasano

doi:10.1016/j.rmcr.2020.101005

Pulmonary nocardiosis caused by Nocardia blacklokiae in an immunocompetent patient

Respir Med Case Rep. 2020 Jan 25:29:101005. doi: 10.1016/j.rmcr.2020.101005. eCollection 2020.

Authors

Affiliations

¹ Department of Respiratory Medicine, Ise Red Cross Hospital, 1-471-2 Funae, Ise, 516-8512, Japan.
² Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8673, Japan.
³ Department of Infectious Disease, Ise Red Cross Hospital, 1-471-2 Funae, Ise, 516-8512, Japan.
⁴ Department of Thoracic Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, 516-8512, Japan.
⁵ Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan.

Abstract

A subset of Nocardia isolates, previously belonging to N. transvalensis, has recently been given the new species designation N. blacklokiae. Here we report a case of pulmonary nocardiosis caused by N. blacklokiae in a 52-year-old immunocompetent woman presenting with low-grade fever and fatigue. The isolated Nocardia strain was resistant to sulfamethoxazole-trimethoprim and amikacin, but susceptible to amoxicillin-clavunate, ceftriaxone, clarithromycin and linezolid. With amoxicillin-clavunate treatment, the patient recovered and her condition remained stable, although recurrence occurred after cessation of the initial treatment. While infection by Nocardia is rare, clinicians should be aware of its resistance to antimicrobials including amikacin and sulfamethoxazole-trimethoprim.

Keywords: Amoxicillin-clavunate; Immunocompetent; Nocardia blacklokiae; Pulmonary nocardiosis.

Publication types

Case Reports