Gülşen HAZIROLAN, Murat AKOVA, Rashad ISMAYILOV, Mine Durusu TANRIÖVER, Gülçin TELLİ DİZMAN, Neslihan KORAY, Neşe İNAL

Atipik anti-glomerüler bazal membran glomerülonefriti tanılı hastada pulmoner tromboemboliyi taklit eden Nocardia abscessus nedenli pulmoner nokardiyozis

Nocardia türleri sıklıkla inhalasyonla bulaşan fırsatçı bakterilerdir. Bunlardan Nocardia abscessus yakın zamanda farklı bir tür olarak tanımlanmıştır. Biz bu çalışmada, taburculuğunun 5. gününde pulmoner tromboembolizmi taklit eden akut plöritik göğüs ağrısı ile başvuran 54 yaşında erkek hastayı sunduk. Hasta yeni tanı atipik anti-glomerüler bazal membran hastalığı nedeniyle immunsupresif tedavi almaktaydı. Göğüs ağrısı etyolojisini araştırmak için çekilen toraks bilgisayarlı tomografisinde sağ akciğer orta lob lateral segmentinde 17x19 mm yumuşak doku lezyonu saptandı. İleri incelemeler sonrası biyopsi kararı alındı ve aspirasyon materyalinin aerobik kültüründe Nocardia abscessus izole edildi.

Pulmonary nocardiosis caused by Nocardia abscessus mimicking pulmonary thromboembolism in a patient with atypical anti-glomerular basement membrane glomerulonephritis

Nocardia species are opportunistic bacteria that are frequently contagious by inhalation. Recently, Nocardia abscessus has been described as a different species. We report a 54-year-old male who presented with acute pleuritic chest pain, mimicking pulmonary thromboembolism on the 5th day of discharge from the hospital. The patient was receiving immunosuppressive therapy for newly diagnosed atypical anti-glomerular basement membrane disease. Thorax computed tomography revealed a 17x19 mm soft tissue lesion in the lateral segment of the middle lobe of the right lung. After further examinations, a biopsy decision was made and Nocardia abscessus was isolated in the aerobic culture of the aspiration material.

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1. Muñoz J, Mirelis B, Aragón LM, Gutiérrez N, Sánchez F, Español M, et al. Clinical and microbiological features of nocardiosis 1997-2003. J Med Microbiol 2007; 56(4): 545-50.
2. Parte AC, Sardà CJ, Meier-Kolthoff JP, Reimer LC, Göker M. List of Prokaryotic names with Standing in Nomenclature (LPSN) moves to the DSMZ. Int J Syst Evol Microbiol 2020; 70(11): 5607-12.
3. Yassin AF, Rainey FA, Mendrock U, Brzezinka H, Schaal KP. Nocardia abscessus sp. nov. Int J Syst Evol Microbiol 2000; 50: 1487-93.
4. Wilson JW. Nocardiosis: updates and clinical overview. Mayo Clin Proc 2012; 87: 403-7.
5. Glupczynski Y, Berhin C, Janssens M, Wauters G. Determination of antimicrobial susceptibility patterns of Nocardia spp. from clinical specimens by Etest. Clin Microbiol Infect 2006; 12(9): 905-12.
6. Woods GL, Wengenack NL, Lin G, Brown-Elliott BA, Cirillo DM, Conville PS, et al. Susceptibility testing of Mycobacteria, Nocardia spp., and other aerobic actinomycetes. 3rd ed. Wayne (PA): Clinical and Laboratory Standards Institute; 2018.
7. Takiguchi Y, Ishizaki S, Kobayashi T, Sato S, Hashimoto Y, Suruga Y, et al. Pulmonary nocardiosis: a clinical analysis of 30 cases. Intern Med 2017; 56(12): 1485-90.
8. Tomás RM, Villanueva RM, Calzada SR, Durantez MS, Manuel J, Tarazona V, et al. Pulmonary nocardiosis : Risk factors and outcomes. Respirology 2007; 12: 394-400.
9. Sato H, Okada F, Mori T, Ono A, Nakayama T, Ando Y, et al. High-resolution computed tomography findings in patients with pulmonary nocardiosis. Acad Radiol 2016; 23(3): 290-6.
10. Lebeaux D, Bergeron E, Berthet J, Djadi-Prat J, Mouniée D, Boiron P, et al. Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010–2015. Clin Microbiol Infect 2019; 25(4): 489-95.