Clinical analysis of pulmonary nocardia infection:2 cases report and literatures review

SHENG Zhaojun; ZHANG Duchao; XU Yaping; LIU Chao; FANG Xiangqun

doi:10.3969/j.issn.1671-6450.2014.10.006

Abstract：Objective To investigate the clinical characteristics , diagnosis and treatment and prognosis of 2 cases with pulmonary nocardia infection .Methods From 2009 to 2011 , 2 patients in PLA General Hospital who were suffering from pulmonary nocardia infection were reported , and searched the domestic literature in the same period with a total of 35 cases, the above 37 patients were analyzed retrospectively .Results Among the 37 cases of pulmonary nocardia infection patients , 26 cases (70.3%) had underlying diseases , 21 cases (56.8%) with glucocorticoids or immunosuppressive treatment history .26 cases with solitary pulmonary infection (70.3%), 11 cases with disseminated infection (29.7%).The main clinical mani-festation of 34 patients was fever (91.9%), 29 cases of cough (78.4%), 25 cases of expectoration (67.6%).In 27 cases (73.0%), chest CT mainly manifested as nodular or mass , 9 cases (24.3%) formed with cavities.37 cases were positively cultured with Nocardia, star Nocardia infection among 19 cases (51.4%), 2 cases of Brazil Nocardia infection (5.4%), un-differentiated type in 16 cases (43.2%).13 patients (35.1%) received compound sulfamethoxazole monotherapy , 16 pa-tients (43.2%) received compound sulfamethoxazole in combination with other drugs , 8 cases (21.6%) were treatment with quinolones , aminoglycosides , beta lactam etc .single or combined , empyema were treated with drainage .Improved or cured in 33 cases (89.2%), invalid in 1 case (2.7%), died of respiratory failure in 3 cases (8.1%).Conclusion Underlying dis-eases and low immune function is basic for pulmonary nocardia infection , chest CT mainly manifested as nodular or mass shad-ows , some accompanied with cavity formation , nocardia positive culture is the only way for diagnosis of the disease , sulfonyl a-mine is the first choice of treatment , when necessary , combined use of other drugs .