Volume 3, Issue 3, September 2018, Page: 62-65
Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report
Santoro Carmen Rita, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Brindicci Gaetano, Operative Unit of Infectious Diseases, AOU Consorziale Policlinico, Bari, Italy
Mazzola Michele, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Giannelli Anna, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Infante Giovanni, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Fiorella Carmen Silvia, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Pappalettera Antonio, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Capodivento Saverio, Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Cascarano Marina, Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Quinto Nicola, Operative Unit of Radiodiagnostic, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Losappio Ruggero, Operative Unit of Infectious Diseases, Ospedale Civile Vittorio Emanuele II, Bisceglie, Italy
Laura Monno, Operative Unit of Infectious Diseases, AOU Consorziale Policlinico, Bari, Italy
Received: Aug. 3, 2018;       Accepted: Sep. 12, 2018;       Published: Oct. 25, 2018
DOI: 10.11648/j.ijidt.20180303.13      View  217      Downloads  13
Abstract
The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.
Keywords
Disseminated Nocardiosis, AIDS, Late Advanced Naive
To cite this article
Santoro Carmen Rita, Brindicci Gaetano, Mazzola Michele, Giannelli Anna, Infante Giovanni, Fiorella Carmen Silvia, Pappalettera Antonio, Capodivento Saverio, Cascarano Marina, Quinto Nicola, Losappio Ruggero, Laura Monno, Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report, International Journal of Infectious Diseases and Therapy. Vol. 3, No. 3, 2018, pp. 62-65. doi: 10.11648/j.ijidt.20180303.13
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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