Infection à Nocardia farcinica chez un patient porteur d’une mucoviscidose [Nocardia farcinica infection in a patient with cystic fibrosis]
| Autor: | Beucher, J., Belleguic, Chantal, Brinchault, Graziella, Deneuville, Eric, Donnio, Pierre-Yves, Roussey, Michel |
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| Přispěvatelé: | Service de pneumologie, Centre de Ressources et de Compétences de la Mucoviscidose, hôpital Sud, Microbiologie : Risques Infectieux, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Brébion, Alice |
| Jazyk: | francouzština |
| Rok vydání: | 2010 |
| Předmět: |
MESH: Bronchiectasis
MESH: Cystic Fibrosis MESH: Pneumonia Bacterial Nocardia farcinica MESH: Nocardia MESH: Bacteriological Techniques Détresse respiratoire MESH: Sputum MESH: Anti-Bacterial Agents Mucoviscidose MESH: Infusions Intravenous MESH: Adolescent [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology MESH: Humans MESH: Pseudomonas Infections MESH: Opportunistic Infections MESH: Male MESH: Recurrence MESH: Drug Therapy Combination MESH: Nocardia Infections MESH: Administration Oral MESH: Pseudomonas aeruginosa MESH: Pneumothorax MESH: Tomography X-Ray Computed MESH: Respiratory Insufficiency [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Revue des Maladies Respiratoires Revue des Maladies Respiratoires, Elsevier Masson, 2010, 27 (1), pp.76-9. ⟨10.1016/j.rmr.2009.08.001⟩ Revue des Maladies Respiratoires, 2010, 27 (1), pp.76-9. ⟨10.1016/j.rmr.2009.08.001⟩ |
| ISSN: | 0761-8425 1776-2588 |
| Popis: | International audience; Infections by Nocardia species are uncommon and generally affect immunocompromised patients. This bacteria has rarely been isolated from cystic fibrosis patients (CF), especially those who are not taking oral corticosteroids. We report a case of a patient with CF harbouring Nocardia farcinica. An 18-year-old male diagnosed with CF at the age of eight (F508 del/G85E) had been treated for allergic bronchopulmonary aspergillosis in 1998 with itraconazole, and a first colonization with Pseudomonas aeruginosa was eradicated in 2003. From May 2006, he presented with recurrent left- and right-sided pneumothorax. In June 2006, he presented with dyspnoea, fever, and nodular eruption on his ankles. Chest X-ray and CT scan revealed a right pneumothorax, severe bronchiectasis and bilateral alveolar consolidation. N. farcinica was idolated from his sputum without any other pathogens. Treatment with intravenous cotrimoxazole associated with imipenem and amikacin was initiated for three weeks followed by oral cotrimoxazole for a further nine months. The patient's symptoms and alveolar consolidation on CT scan improved. During 2007, his respiratory condition worsened and his FEV(1) declined from 50 to 26 % predicted. His pneumothorax recurred. He had chronic colonization with P. aeruginosa and was on the list for lung transplantation. Nocardia, a Gram positive bacillus, causes mainly pulmonary infection, usually in the context of immune suppression. The most frequent species is N. asteroides. In CF, very few cases have been reported; almost always N. asteroides, but exceptionally N. farcinica. In CF patients with worsening pulmonary condition, Nocardia should be considered, as well as other unusual pathogens. |
| Databáze: | OpenAIRE |
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