TY - JOUR
T1 - Nocardia bacteremia
T2 - Report of 4 cases and review of the literature
AU - Kontoyiannis, Dimitrios P.
AU - Ruoff, Kathryn
AU - Hooper, David C.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998/7
Y1 - 1998/7
N2 - 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.
AB - 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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U2 - 10.1097/00005792-199807000-00004
DO - 10.1097/00005792-199807000-00004
M3 - Review article
C2 - 9715730
AN - SCOPUS:0031845748
SN - 0025-7974
VL - 77
SP - 255
EP - 267
JO - Medicine
JF - Medicine
IS - 4
ER -