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Volume 29, Number 4—April 2023
CME ACTIVITY - Synopsis

Nocardia pseudobrasiliensis Co-infection in SARS-CoV-2 Patients

Daniel Beau Stamos, Aldo Barajas-Ochoa, and Jillian E. RaybouldComments to Author 
Author affiliation: Virginia Commonwealth University Health System, Richmond, Virginia, USA

Main Article

Table 2

Nocardiosis infections reported during or shortly after COVID-19 infection, 2021*

Study Age, y/sex Nocardia species; positive culture site(s) Days from SARS-CoV-2 diagnosis to Nocardia diagnosis Site(s) of Nocardia infection Predisposing factor On MV? Steroids before Nocardia diagnosis Susceptibilities Final therapy Outcome
Colaneri et al. (5)
 45/F
 N. cryarcigeorgica; subcutaneous lumps, lower respiratory tract sputum smear and culture
 5 d
 Lung, skin, kidney
 AIDS
 No
 Hydrocortisone for persistent fever
 Susceptible: TMP/SMX, amikacin, linezolid; resistant: AMO/CLA, third-generation cephalosporins, quinolones
 Tedizolid for 1 wk followed by 1 y TMP/SMX
 Survived
Arif et al. (6)
 61/F
 N. farcinica; Gram stain of pulmonary nodule biopsy
 10 d
 Lung
 Type 2 diabetes mellitus
 No
 Dexamethasone for COVID-19
 NA
 TMP/SMX and linezolid
 Survived
Atemnkeng et al. (7)
 63/M
 N. asteroids; bronchial lavage culture
 50 d
 Lung, brain
 Type 2 diabetes mellitus
 No
 Dexamethasone for COVID-19
 Resistant: carbapenem
 TMP/SMX and linezolid for 1 y
 Survived
Kaur and Bhatti (8)
 80/F
 N. farcinica; Gram stain and culture of brain abscess biopsy
 >10 d, exact date unspecified
 Brain
 Advanced age
 No
 Dexamethasone for COVID-19
 NA
 TMP/SMX, ceftriaxone, doxycycline
 Not reported
Driscoll et al. 2022 (9)
 16/M
 N. farcinica; lower airway samples
 9 d
 Lung
 Cystic fibrosis, bronchiectasis
 Yes
 Dexamethasone for COVID-19
 NA
 Linezolid
 Died
Cicero et. al. 2022 (10)
 79/M
 N. otitidiscaviarum: sputum culture
 17 d
 Lung
 COPD, previous pulmonary tuberculosis, cirrhosis
 No
 Methylpredisolone for COVID-19
 Susceptible: ceftriaxone, amikacin, ciprofloxacin, meropenem, TMP/SMX
 Not given
 Died
Velickovic et al. 2022 (11)
 30/F
 N. cyriacigeorgica; brain abscess
 200 d
 Brain
 Systemic lupus erythematosus, glucocorticoid therapy, CD4 count <100
 No
 Prednisone for systemic lupus erythematosus
 Susceptible: TMP/SMX, ceftriaxone, cefotaxime, imipenem, linezolid; resistant: ampicillin, AMO/CLA, fluoroquinolones
 TMP/SMX
 Survived
DiMeglio et al. 2022 (12)
 70/M
 N. farcinica: spinal cord abscess
 48 d
 Brain and spinal cord
 Diabetes mellitus, advanced age, glucocorticoid therapy
 No
 Dexamethasone for COVID-19
 NR
 TMP/SMX, linezolid
 Died
Laplace et al. 2022 (13)
 83/M
 N. cyriacigeorgica: sputum culture
 4 d
 Lung
 Advanced age
 No
 Dexamethasone for COVID-19
 NR
 Imipenem, cotrimoxazole
 Died
This study 52/M N. pseudobrasiliensis: sputum gram stain 7 d Lung Bronchiectasis, sarcoidosis, immunosuppressive therapy, type 2 diabetes mellitus No Dexamethasone for COVID-19 Susceptible: amikacin, ciprofloxacin, clarithromycin, linezolid, moxifloxacin, tobramycin, TMP/SMX; resistant: AMO/CLA, doxycycline, imipenem, minocycline Linezolid, ciprofloxacin Survived

*AMO/CLA, amoxicillin/clavulanic acid; COPD, chronic obstructive pulmonary disease; MV, mechanical ventilation; NA, not available; NR, not reported; TMP/SMX, trimethoprim/sulfamethoxazole.

Main Article

References
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Page created: February 01, 2023
Page updated: March 22, 2023
Page reviewed: March 22, 2023
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