Nocardia cyriacigeorgica infection in a patient with repeated fever and CD4+T cell deficiency:A case report  

作　　者：Xin Hong You-Qi Ji Meng-Yuan Chen Xiao-Yu Gou Yu-Mei Ge 

机构地区：[1]Department of Green Pharmaceutical Collaborative Innovation Center,School of Pharmacy,Zhejiang University of Technology,Hangzhou 310014,Zhejiang Province,China [2]School of Medical Technology and Information Engineering,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China [3]The Second Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China [4]Department of Clinical Laboratory,Zhejiang Provincial People's Hospital(Affiliated People's Hospital,Hangzhou Medical College),Hangzhou 310014,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第5期1175-1181,共7页世界临床病例杂志

摘　　要：BACKGROUND Nocardia pneumonia shares similar imaging and clinical features with pulmonary tuberculosis and lung neoplasms,but the treatment and anti-infective medication are completely different.Here,we report a case of pulmonary nocardiosis caused by Nocardia cyriacigeorgica(N.cyriacigeorgica),which was misdiagnosed as community-acquired pneumonia(CAP)with repeated fever.CASE SUMMARY A 55-year-old female was diagnosed with community-acquired pneumonia in the local hospital because of repeated fever and chest pain for two months.After the anti-infection treatment failed in the local hospital,the patient came to our hospital for further treatment.Enhanced computed tomography showed multiple patchy,nodular and strip-shaped high-density shadows in both lungs.A routine haematological examination was performed and showed abnormalities in CD19+B cells and CD4+T cells.Positive acid-fast bifurcating filaments and branching gram-positive rods were observed in the bronchoalveolar lavage fluid of the patient under an oil microscope,which was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry as N.cyriacigeorgica.The patient’s condition quickly improved after taking 0.96 g compound sulfamethoxazole tablets three times a day.CONCLUSION The antibiotic treatment of Nocardia pneumonia is different from that of common CAP.Attention should be given to the pathogenic examination results of patients with recurrent fever.Nocardia pneumonia is an opportunistic infection.Patients with CD4+T-cell deficiency should be aware of Nocardia infection.

关 键 词：Nocardia pneumonia Nocardia cyriacigeorgica Matrix-assisted laser desorption ionization-time of flight mass spectrometry INFECTION Lung CD4+T-cell Case report 

分 类 号：R756[医药卫生—皮肤病学与性病学]