Nocardia is a significant opportunistic pathogen in patients with compromised immunity. The authors isolated N. asteroides from an abscess of the axilla and from respiratory specimens of a renal allograft patient with pneumonia. Direct smear of the sputum and bronchial washing specimens showed many branching, filamentous forms which were gram-positive and acid fast. Culture yielded slow growing small white colonies which became orange on further incubation. Aerial hyphae were produced. Identification of the species was based on typical cultural and biochemical tests. The isolate was susceptible to amikacin, minocycline and rifamipicin. The patient became afebrile after 8 weeks of treatment with cotrimoxazole and brief treatment with other antimicrobial agents.
Adult ; Human ; Kidney Transplantation* ; Lung Diseases/etiology* ; Male ; Nocardia Infections/etiology* ; Nocardia asteroides/isolation & purification

In order to explore the diagnosis and therapeutic effectiveness of nocardiosis after allogenic hematopoietic stem cell transplantation (allo-HSCT), the features of clinical manifestation, laboratory examination and response to TMP-SMZ treatment in two cases of nocardiosis after allo-HSCT were analyzed retrospectively. The result showed that the attack happened to 2 patients at day 15 and 170 after allo-HSCT respectively, displaying fever and chest pain. Chest CT scan indicated bilateral pulmonary tuberculous shadow. Nocardiosis was diagnosed by the culture of sputum, bronchoalveolar lavage (BAL) fluid and pus samples as well. Both of these cases exhibited good response to combined therapy containing TMP-SMZ for half a year. It is concluded that nocardiosis is a rare complication after allo-HSCT, in which pulmonary involvement is commonly observed. The culture of BAL fluid is helpful for its diagnosis and this disease might be sensitive to the treatment of TMP-SMZ-containing regimens.
Adolescent ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Nocardia Infections ; etiology ; Retrospective Studies ; Transplantation, Homologous