Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis
Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbi...
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| Format: | Article |
| Language: | English |
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Elsevier
2011-07-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867011702100 |
| _version_ | 1819044761514803200 |
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| author | Jussara Bianchi Castelli, MD, PhD Rinaldo Focaccia Siciliano, MD Edson Abdala, MD, PhD Vera Demarchi Aiello, MD, PhD |
| author_facet | Jussara Bianchi Castelli, MD, PhD Rinaldo Focaccia Siciliano, MD Edson Abdala, MD, PhD Vera Demarchi Aiello, MD, PhD |
| author_sort | Jussara Bianchi Castelli, MD, PhD |
| collection | DOAJ |
| description | Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IE caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients. Keywords: mitral valve, endocarditis, bacterial, Nocardia infections |
| first_indexed | 2024-12-21T10:17:49Z |
| format | Article |
| id | doaj.art-0cdd0276343c4b108b8f4b05550e3fa9 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-21T10:17:49Z |
| publishDate | 2011-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-0cdd0276343c4b108b8f4b05550e3fa92022-12-21T19:07:32ZengElsevierBrazilian Journal of Infectious Diseases1413-86702011-07-01154384386Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosisJussara Bianchi Castelli, MD, PhD0Rinaldo Focaccia Siciliano, MD1Edson Abdala, MD, PhD2Vera Demarchi Aiello, MD, PhD3Laboratory of Pathology, InCor, Medical School, Universidade de São Paulo (USP), Brazil; Correspondence to: Laboratory of Pathotological Anatomy, InCor - HCFMUSP, Av. Dr. Eneas de Carvalho Aguiar, 44, 05403-000, São Paulo, SP Brazil.Infection Control Unit, InCor, Medical School, USP, BrazilLiver Tranplant Service, Gastroenterology Department, Medical School, USP, BrazilLaboratory of Pathology, InCor, Medical School, Universidade de São Paulo (USP), BrazilNocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IE caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients. Keywords: mitral valve, endocarditis, bacterial, Nocardia infectionshttp://www.sciencedirect.com/science/article/pii/S1413867011702100 |
| spellingShingle | Jussara Bianchi Castelli, MD, PhD Rinaldo Focaccia Siciliano, MD Edson Abdala, MD, PhD Vera Demarchi Aiello, MD, PhD Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis Brazilian Journal of Infectious Diseases |
| title | Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis |
| title_full | Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis |
| title_fullStr | Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis |
| title_full_unstemmed | Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis |
| title_short | Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis |
| title_sort | infectious endocarditis caused by nocardia sp histological morphology as a guide for the specific diagnosis |
| url | http://www.sciencedirect.com/science/article/pii/S1413867011702100 |
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