1887

Journal of Medical Microbiology logo

Volume 59, Issue 2

: a case of endocarditis with disseminated soft-tissue infection Free

Abstract

is a common environmental organism. It has been isolated from clinical samples in Europe, Asia and North America, predominantly from respiratory samples but also from samples from several other sites. We present a case report of an 85-year-old female patient in the UK who was found to have a multi-focal soft-tissue infection from which was isolated. She had a background history of chronic obstructive pulmonary disease and corticosteroid use for polymyalgia rheumatica. During the course of her treatment echocardiography showed the presence of a mobile heart mass attached to a valve leaflet, a major Dukes criterion for endocarditis. We suggest that in cases of disseminated infection, endocarditis should be tested for, particularly in cases failing to respond to treatment. We also review previous reports of both infection, and of endocarditis due to species and related genera.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): SOP, standard operating procedure
SGM
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.011593-0
2010-02-01
2024-04-16
Loading full text...

Full text loading...

/deliver/fulltext/jmm/59/2/224.html?itemId=/content/journal/jmm/10.1099/jmm.0.011593-0&mimeType=html&fmt=ahah

References

  1. Akcaglar S., Yilmaz E., Heper Y., Alver O., Akalin H., Ener B., Tore O., Ersoy C., Imamoglu S. 2008; Nocardia cyriacigeorgica : pulmonary infection in a patient with Basedow-Graves disease and a short review of reported cases. Int J Infect Dis 12:335–338 [CrossRef]
     [Google Scholar]
  2. Alcaide M. L., Espinoza L., Abbo L. 2004; Cavity pneumonia secondary to Tsukamurella in an AIDS patient. First case and a review of the literature. J Infect 49:17–79 [CrossRef]
     [Google Scholar]
  3. Allevato P. A., Eisses J. F., Mezger E., Fisher E. J., Romig D. A., Morales A. R. 1985; Nocardia asteroides aortitis with perforation of the aorta. Hum Pathol 16:743–746 [CrossRef]
     [Google Scholar]
  4. Almehmi A., Pfister A. K., McCowan R., Matulis S. 2004; Implantable cardioverter-defibrillator infection caused by Tsukamurella . W V Med J 100:185–186
     [Google Scholar]
  5. Almuzara M. N., de Meer C., Rodríguez C. R., Famiglietti A. M. R., Vay C. A. 2006; Evaluación del sistema API Coryne, versión 2.0, para la identificación de bacilos gram-positivos difteroides de importancia clínica. Rev Argent Microbiol 38:197–201
     [Google Scholar]
  6. Alp E., Yildiz O., Aygen B., Sumerkan B., Sari I., Koc K., Couble A., Laurent F., Boiron P., Doganay M. 2006; Disseminated nocardiosis due to unusual species: two case reports. Scand J Infect Dis 38:545–548 [CrossRef]
     [Google Scholar]
  7. Alric L., Chauvet E., Toulemonde P., Duffaut M. 2002; Infection à Rhodococcus equi une cause rare de vascularite cutanée. Rev Med Interne 23:569–571 [CrossRef]
     [Google Scholar]
  8. Antonovich D. D., Berke A., Grant-Kels J. M., Fung M. 2004; Infectious eccrine hidradenitis caused by Nocardia . J Am Acad Dermatol 50:315–318 [CrossRef]
     [Google Scholar]
  9. Antony S. J., Stivers M., Rivera J. O. 2006; Endocarditis/endovascular infection associated with Nocardia . Infect Med 23:262–266
     [Google Scholar]
  10. Ayral X., Piette A. M., Roullet-Audy J. C., Gepner P., Bailet A., Baglin A. C., Chapman A. 1989; Endocardite à Nocardia asteroides sur bioprothèse aortique compliquée d'anévrysmes mycotiques hépatiques. Ann Med Interne 140:652–654
     [Google Scholar]
  11. Baddour L. M., Wilson W. R., Bayer A. S., Fowler V. G. Jr, Bolger A. F., Levison M. E., Ferrieri P., Gerber M. A., Tani L. Y. other authors 2005; Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications. Circulation 111:e394–e434 [CrossRef]
     [Google Scholar]
  12. Barnaud G., Deschamps C., Manceron V., Mortier E., Laurent F., Bert F., Boiron P., Vinceneux P., Branger C. 2005; Brain abscess caused by Nocardia cyriacigeorgica in a patient with human immunodeficiency virus infection. J Clin Microbiol 43:4895–4897 [CrossRef]
     [Google Scholar]
  13. Bemer-Melchior P., Haloun A., Riegel P., Drugeon H. B. 1999; Bacteremia due to Dietzia maris in an immunocompromised patient. Clin Infect Dis 29:1338–1340 [CrossRef]
     [Google Scholar]
  14. Bishara J., Robenshtok E., Weinberger M., Yeshurun M., Sagie A., Pitlik S. 1999; Infective endocarditis in renal transplant recipients. Transpl Infect Dis 1:138–143 [CrossRef]
     [Google Scholar]
  15. Blaschke A. J., Bender J., Byington C. L., Korgenski K., Daly J., Petti C. A., Pavia A. T., Ampofo K. 2007; Gordonia species: emerging pathogens in pediatric patients that are identified by 16S ribosomal RNA gene sequencing. Clin Infect Dis 45:483–486 [CrossRef]
     [Google Scholar]
  16. Bosshard P. P., Abels S., Zbinden R., Bőttger E. C., Altwegg M. 2003; Ribosomal DNA sequencing for identification of aerobic gram-positive rods in the clinical laboratory (an 18-month evaluation). J Clin Microbiol 41:4134–4140 [CrossRef]
     [Google Scholar]
  17. Bouza E., Pérez-Parra A., Rosal M., Martín-Rabadán P., Rodríguez-Créixems M., Marín M. 2009; Tsukamurella : a cause of catheter-related bloodstream infections. Eur J Clin Microbiol Infect Dis 28:203–210 [CrossRef]
     [Google Scholar]
  18. Breitkopf C., Hammel D., Scheld H. H., Peters G., Becker K. 2005; Impact of a molecular approach to improve the microbiological diagnosis of infective heart valve endocarditis. Circulation 111:1415–1421 [CrossRef]
     [Google Scholar]
  19. Brouqui P., Raoult D. 2001; Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev 14:177–207 [CrossRef]
     [Google Scholar]
  20. Brown-Elliott B. A., Brown J. M., Conville P. S., Wallace R. J. Jr 2006; Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 19:259–282 [CrossRef]
     [Google Scholar]
  21. Chain S., Luciardi H., Feldman G., Berman S., Estrella C. 2007; Endocarditis infecciosa por Nocardia en valvulas nativas aortica y tricuspide. Medicina (B Aires) 67:279–281
     [Google Scholar]
  22. Chedid M. B. F., Chedid M. F., Porto N. S., Severo C. B., Severo L. C. 2007; Nocardial infections: report of 22 cases. Rev Inst Med Trop Sao Paulo 49:239–246
     [Google Scholar]
  23. Chong Y., Lee K., Chon C. Y., Kim M. J., Kwon O. H., Lee H. J. 1997; Tsukamurella inchonensis bacteraemia in a patient who ingested hydrochloric acid. Clin Infect Dis 24:1267–1268 [CrossRef]
     [Google Scholar]
  24. Conville P. S., Witebsky F. G. 2007; Organisms designated as Nocardia asteroides drug pattern type VI are members of the species Nocardia cyriacigeorgica . J Clin Microbiol 45:2257–2259 [CrossRef]
     [Google Scholar]
  25. Daikos G. L., Syriopoulou V., Horianpoulou M., Kanellopoulou M., Martsoukou M., Papafrangas E. 2003; Successful antimicrobial chemotherapy for Nocardia asteroides prosthetic valve endocarditis. Am J Med 115:330–332
     [Google Scholar]
  26. Dhawan V. K., Gadgil U. G., Paliwal Y. K., Chaurushiya P. S., Trivedi R. R. 1998; Native valve endocarditis due to a Nocardia -like organism. Clin Infect Dis 27:902–904 [CrossRef]
     [Google Scholar]
  27. Eigel P., Elert O., Hopp H., Silber R., Romen W., Schmidt-Rotte H. 1988; Nocardial endocarditis after aortic valve replacement: reports of two cases. Scand J Thorac Cardiovasc Surg 22:289–290 [CrossRef]
     [Google Scholar]
  28. Ellerbroek P., Kuipers S., Rozenberg-Arska M., Verdonck L. F., Petersen E. J. 1998; Oerskovia xanthineolytica : a new pathogen in bone marrow transplantation. Bone Marrow Transplant 22:503–505 [CrossRef]
     [Google Scholar]
  29. Elsayed S., Kealey A., Coffin C. S., Read R., Megran D., Zhang K. 2006; Nocardia cyriacigeorgica septicemia. J Clin Microbiol 44:280–282 [CrossRef]
     [Google Scholar]
  30. Ertl G., Schaal K. P., Kochsiek K. 1987; Nocardial endocarditis of an aortic valve prosthesis. Br Heart J 57:384–386 [CrossRef]
     [Google Scholar]
  31. Falk R. H., Dimock F. R., Sharkey J. 1979; Prosthetic valve endocarditis resulting from Nocardia asteroides . Br Heart J 41:125–127 [CrossRef]
     [Google Scholar]
  32. Fux C., Bodmer T., Ziswiler H. R., Leib S. L. 2003; Nocardia cyriacigeorgici : erstbeschreibung als invasive infektion. Dtsch Med Wochenschr 128:1038–1041 [CrossRef]
     [Google Scholar]
  33. Gabriels P., Joosen H., Put E., Verhaegan J., Magerman K., Cartuyvela R. 2006; Recurrent Rhodococcus equi infection with fatal outcome in an immunocompetent patient. Eur J Clin Microbiol Infect Dis 25:46–48 [CrossRef]
     [Google Scholar]
  34. Gates J. D., Warth J. A., McGowan K. 2006; Nocardia asteroides -infected aneurysm of the aorta: case report and review of the literature. Vascular 14:165–168 [CrossRef]
     [Google Scholar]
  35. HPA 2006 Investigation of Skin, Superficial and Non-surgical Wound Swabs, National Standard Method BSOP 11, issue 4 London: Health Protection Agency; http://www.hpa-standardmethods.org.uk/pdf_sops.asp
     [Google Scholar]
  36. HPA 2008 Investigation of Abscesses and Deep Seated Wound Infections , National Standard Method BSOP 14, issue x London: Health Protection Agency; http://www.hpa-standardmethods.org.uk/pdf_sops.asp
     [Google Scholar]
  37. Jones R. S., Fekete T., Truant A. L., Satishchandran V. 1994; Persistent bacteremia due to Tsukamurella paurometabolum in a patient undergoing hemodialysis: case report and review. Clin Infect Dis 18:830–832 [CrossRef]
     [Google Scholar]
  38. Kageyama A., Yazawa K., Ishikawa J., Hotta K., Nishimura K., Mikami Y. 2004; Nocardial infections in Japan from 1992 to 2001, including the first report of infection by Nocardia transvalensis . Eur J Epidemiol 19:383–389
     [Google Scholar]
  39. Kageyama A., Hoshino Y., Yazawa K., Poonwan N., Takeshita N., Maki S., Mikami Y. 2005; Nocardia cyriacigeorgica is a significant pathogen responsible for nocardiosis in Japan and Thailand. Mycopathologia 160:15–19 [CrossRef]
     [Google Scholar]
  40. Kedlaya I., Ing M. B., Wong S. S. 2001; Rhodococcus equi infections in immunocompromised hosts: case report and review. Clin Infect Dis 32:e39–e47 [CrossRef]
     [Google Scholar]
  41. Lalitha P., Tiwari M., Prajna N. V., Prakash K., Srinivasan M. 2007; Nocardia keratitis: species, drug sensitivities, and clinical correlation. Cornea 26:255–259 [CrossRef]
     [Google Scholar]
  42. Lazo Torres A. M., Gálvez Contreras C., Collado Romacho A., Gamir Ruiz F. J., Yélamos Rodríguez F., López Martínez G. 2004; Endocarditis por Nocardia en la válvula mitral nativa. Rev Esp Cardiol 57:787–788 [CrossRef]
     [Google Scholar]
  43. Leonard A., Raij L., Comty C. M., Wathen R., Rattazzi T., Shapiro F. L. 1973; Experience with endocarditis in a large kidney disease program. Trans Am Soc Artif Intern Organs 19:298–301 [CrossRef]
     [Google Scholar]
  44. Lesens O., Hansmann Y., Riegel P., Heller R., Benaissa-Djellouli M., Martinot M., Petit H., Christmann D. 2000; Bacteremia and endocarditis caused by a Gordonia species in a patient with a central venous catheter. Emerg Infect Dis 6:382–385 [CrossRef]
     [Google Scholar]
  45. Maltez F., Serrano A., Proenca R. 1996; Simultaneous infection with Rhodococcus equi , Aspergillus fumigatus and Serratia marcescens in an AIDS patient. In XI International Conference on AIDS Vancouver, 7–12 July 2006. abstract Tu.B.2175
    [Google Scholar]
  46. Maraki S., Panagiotaki E., Tsopanidis D., Scoulica E., Miari N.-M., Hainis K., Dotis G., Katsoula I., Tselentis Y. 2006; Nocardia cyriacigeorgica pleural empyema in an immunocompromised patient. Diagn Microbiol Infect Dis 56:333–335 [CrossRef]
     [Google Scholar]
  47. McNeil M. M., Brown J. M. 1992; Distribution and antimicrobial susceptibility of Rhodococcus equi from clinical specimens. Eur J Epidemiol 8:437–443 [CrossRef]
     [Google Scholar]
  48. Muñoz J., Mirelis B., Aragón L. M., Gutiérrez N., Sánchez F., Español M., Esparcia O., Gurguí M., Domingo P., Coll P. 2007; Clinical and microbiological features of nocardiosis 1997–2003. J Med Microbiol 56:545–550 [CrossRef]
     [Google Scholar]
  49. Niehues R., Schluter S., Kramer A., Klein R. M., Strauer B. E., Schaal K. P., Horstkotte D. 1996; Systemische Nocardia - asteroides -infektion mit endkardbeteiligung unter immunsuppressiver therapie. Dtsch Med Wochenschr 121:1390–1395 [CrossRef]
     [Google Scholar]
  50. Pidoux O., Argenson J.-N., Jacomo V., Drancourt M. 2001; Molecular identification of a Dietzia maris hip prosthesis infection isolate. J Clin Microbiol 39:2634–2636 [CrossRef]
     [Google Scholar]
  51. Poonwan N., Mekha N., Yazawa K., Thunyaharn S., Yamanaka A., Mikami Y. 2005; Characterisation of clinical isolates of pathogenic Nocardia strains and related actinomycetes in Thailand from 1996 to 2003. Mycopathologia 159:361–368 [CrossRef]
     [Google Scholar]
  52. Prescott J. F. 1991; Rhodococcus equi : an animal and human pathogen. Clin Microbiol Rev 4:20–34
     [Google Scholar]
  53. Reyes G., Navarro J.-L., Gamallo C., de las Cuevas M.-C. 2006; Type A aortic dissection associated with Dietzia maris . Interact Cardiovasc Thorac Surg 5:666–668 [CrossRef]
     [Google Scholar]
  54. Ricaurte J. C., Klein O., LaBombardi V., Martinez V., Serpe A., Joy M. 2001; Rothia dentocariosa endocarditis complicated by multiple intracranial hemorrhages. South Med J 94:438–440 [CrossRef]
     [Google Scholar]
  55. Schlaberg R., Huard R. C., Della-Latta P. 2008; Nocardia cyriacigeorgica , an emerging pathogen in the United States. J Clin Microbiol 46:265–273 [CrossRef]
     [Google Scholar]
  56. Schwartz M. A., Tabet S. R., Collier A. C., Wallis C. K., Carlson L. C., Nguyen T. T., Kattar M. M., Coyle M. B. 2002; Central venous catheter-related bacteremia due to Tsukamurella species in the immunocompromised host: a case series and review of the literature. Clin Infect Dis 35:e72–e77 [CrossRef]
     [Google Scholar]
  57. Shapiro C. L., Haft R. F., Gantz N. M., Doern G. V., Christenson J. C., O'Brien R., Overall J. C., Brown B. A., Wallace R. J. Jr 1992; Tsukamurella paurometabolum : a novel pathogen causing catheter-related bacteremia in patients with cancer. Clin Infect Dis 14:200–203 [CrossRef]
     [Google Scholar]
  58. Sheridan E. A. S., Warwick S., Chan A., Antonia M. D., Koliou M., Sefton A. 2003; Tsukamurella tyosinosolvens intravascular catheter infection identified using 16S ribosomal DNA sequencing. Clin Infect Dis 36:e69–e70 [CrossRef]
     [Google Scholar]
  59. Stackebrandt E., Rainey F. A., Ward-Rainey N. L. 1997; Proposal for a new hierarchic classification system, Actinobacteria classis nov. Int J Syst Bacteriol 47:479–491 [CrossRef]
     [Google Scholar]
  60. Torres-Tortosa M., Arrizabalaga J., Villanueva J. L., Gálvez J., Leyes M., Valencia M. E., Flores J., Peña J. M., Pérez-Cecilia E., Quereda C. 2003; Prognosis and clinical evaluation of infection caused by Rhodococcus equi in HIV-infected patients. Chest 123:1970–1976 [CrossRef]
     [Google Scholar]
  61. Tuon F. F., Siciliano R. F., Al-Musawi T., Rossi F., Capelozzi V. L., Gryschek R. C., Medeiros E. A. S. 2007; Rhodococcus equi bacteremia with lung abscess misdiagnosed as Corynebacterium. A report of 2 cases. Clinics 62:795–798 [CrossRef]
     [Google Scholar]
  62. Verma P., Brown J. M., Nunez V. H., Morey R. E., Steigerwalt A. G., Pellegrini G. J., Kessler H. A. 2006; Native valve endocarditis due to Gordonia polyisoprenivorans : case report and review of literature of bloodstream infections caused by Gordonia species. J Clin Microbiol 44:1905–1908 [CrossRef]
     [Google Scholar]
  63. Vlachakis N. D., Gazes P. C., Hairston P. 1973; Nocardial endocarditis following mitral valve replacement. Chest 63:276–278 [CrossRef]
     [Google Scholar]
  64. Watson A., French P., Wilson M. 2001; Nocardia asteroides native valve endocarditis. Clin Infect Dis 32:660–661 [CrossRef]
     [Google Scholar]
  65. Wauters G., Avesani V., Charlier J., Janssens M., Vaneechoutte M., Delmée M. 2005; Distribution of Nocardia species in clinical samples and their routine rapid identification in the laboratory. J Clin Microbiol 43:2624–2628 [CrossRef]
     [Google Scholar]
  66. Yassin A. F., Rainey F. A., Steiner U. 2001; Nocardia cyriacigeorgici sp. nov. Int J Syst Evol Microbiol 51:1419–1423
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.011593-0
Loading
Nocardia cyriacigeorgica: a case of endocarditis with disseminated soft-tissue infection
J. Med. Microbiol. 59, 224 (2010); https://doi.org/10.1099/jmm.0.011593-0
/content/journal/jmm/10.1099/jmm.0.011593-0
/content/journal/jmm/10.1099/jmm.0.011593-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error