Nocardia infection is rare but potentially fatal. Therapy of Nocardia infection remains difficult. Linezolid, a novel oxazolidinone antibiotic, has proven to be effective, but clinical data are limited. Here we describe a case of a 45-year-old man with pulmonary N. farcinica infection following a liver transplantation. The initial therapy was trimethoprim-sulfamethoxazole, which showed no effect. According to susceptibility test, linezolid was administered with clearly improving the patient's condition. The treatment was stopped for anemia as drug related adverse event, and the therapy lasted for as long as 5 months. At the end of treatment clinical cure was confirmed and anemia reversed after discontinuation of linezolid. We also analyzed the clinical data of previously published reports by literature review, focusing on the efficacy and safety of linezolid treatment for Nocardia infection.
Journal Information
Vol. 15. Issue 5.
Pages 486-489 (September - October 2011)
Vol. 15. Issue 5.
Pages 486-489 (September - October 2011)
Case report
Open Access
Successful treatment of pulmonary Nocardia farcinica infection with linezolid: case report and literature review
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Tian Shen, Lihua Wu, Lei Geng, Zeqing Wei, Shusen Zheng
Corresponding author
shentian17@yahoo.com.cn
Correspondence to: First Affiliated Hospital Zhejiang University School of Medicine Qingchun Road 79# Hangzhou 310003, China.
Correspondence to: First Affiliated Hospital Zhejiang University School of Medicine Qingchun Road 79# Hangzhou 310003, China.
Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Article information
Abstract
Keywords:
Nocardia
linezolid
drug therapy
transplantation
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References
[1.]
B.A. Brown-Elliott, J.M. Brown, P.S. Conville, et al.
Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy.
Clin Microbiol Rev, 19 (2006), pp. 259-282
[2.]
R.L. Deem, F.A. Doughty, B.L. Beaman.
Immunologically specific direct T lymphocyte-mediated killing of Nocardia asteroides.
J Immunol, 130 (1983), pp. 2401-2406
[3.]
N.M. Clark.
Nocardia in solid organ transplant recipients.
Am J Transplant, 9 (2009), pp. S70-S77
[4.]
A.Y. Peleg, S. Husain, Z.A. Qureshi, et al.
Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: A matched case-control study.
Clin Infect Dis, 44 (2007), pp. 1307-1314
[5.]
J.L. del Pozo, J.I. Herrero, A. Manubens, et al.
Disseminated Nocardia asteroides infection presenting as an atraumatic leg fracture in a liver transplant recipient.
Liver Transpl, 14 (2008), pp. 257-258
[6.]
Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 6th ed. New York: Churchill Livingstone; 2005.
[7.]
G.A. Noskin, F. Siddiqui, V. Stosor, et al.
In vitro activities of linezolid against important gram-positive bacterial pathogens including vancomycin-resistant enterococci.
Antimicrob Agents Chemother, 43 (1999), pp. 2059-2062
[8.]
B.A. Brown-Elliott, S.C. Ward, C.J. Crist, et al.
In vitro activities of linezolid against multiple Nocardia species.
Antimicrob Agents Chemother, 45 (2001), pp. 1295-1297
[9.]
E.H. Moylett, S.E. Pacheco, B.A. Brown-Elliott, et al.
Clinical experience with linezolid for the treatment of Nocardia infection.
Clin Infect Dis, 36 (2003), pp. 313-318
[10.]
K.E. Lewis, P. Ebden, S.L. Wooster, et al.
Multi-system Infection with Nocardia farcinica-therapy with linezolid and minocycline.
J Infect, 46 (2003), pp. 199-202
[11.]
R.K. Moitra, C. Auckland, M.I. Cawley, et al.
Systemic nocardiosis in a splenectomized patient with systemic lupus erythematosus: successful treatment using linezolid.
J Clin Rheumatol, 9 (2003), pp. 47-50
[12.]
T.A. Rupprecht, H.W. Pfister.
Clinical experience with linezolid for the treatment of central nervous system infections.
Eur J Neurol, 12 (2005), pp. 536-542
[13.]
S.M. Viganò, A. Edefonti, M. Ferraresso, et al.
Successful medical treatment of multiple brain abscesses due to Nocardia farcinica in a paediatric renal transplant recipient.
Pediatr Nephrol, 20 (2005), pp. 1186-1188
[14.]
M. Justiniano, S. Glorioso, S. Dold, et al.
Nocardia brain abscesses in a male patient with SLE: successful outcome despite delay in diagnosis.
Clin Rheumatol, 26 (2007), pp. 1020-1022
[15.]
A. Rivero, M. García-Lázaro, I. Pérez-Camacho, et al.
Successful long-term treatment with linezolid for disseminated infection with multiresistant Nocardia farcinica.
Infection, 36 (2008), pp. 389-391
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