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Nocardia bacteremia. Report of 4 cases and review of the literature.

Abstract

Bacteremic nocardiosis is reported rarely. We discuss 4 recent cases seen at our institution and 32 other cases described in the English literature. We found that patients with bacteremic nocardiosis were similar in presentation, risk factors, course, and therapeutic outcome to nonbacteremic patients with nocardiosis. The presence of endovascular foreign bodies appeared to be the only unique risk factor associated with bacteremic illness. Seeding of the central nervous system appeared to be relatively uncommon. Thirty percent of patients with nocardemia had concomitant bacteremia with other pathogens, mostly Gram-negative organisms. Nocardia grew in a variety of growth media, and the median incubation time to detection was 4 days. Fifty percent of patients with Nocardia bacteremia died. Positive blood cultures were a preterminal finding in the fatal, acute cases and occurred relatively early in the subacute, nonfatal cases. Poor outcome seemed to correlate with acute onset of nocardiosis (duration less than 1 month), late identification of nocardemia, involvement of more than 2 sites, and the lack of treatment with a sulfonamide-containing regimen.

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  • Publisher Full Text
  • Authors

    Kontoyiannis DP, Ruoff K, Hooper DC

    Source

    Medicine 77:4 1998 Jul pg 255-67

    MeSH

    Adult
    Aged
    Anti-Bacterial Agents
    Bacteremia
    Female
    Humans
    Kidney Transplantation
    Leukemia, Lymphocytic, Chronic, B-Cell
    Liver Transplantation
    Male
    Middle Aged
    Nocardia Infections
    Prognosis
    Recurrence
    Retrospective Studies
    Risk Factors
    Treatment Outcome

    Pub Type(s)

    Case Reports
    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    9715730