Pulmonary nocardiosis complicated with Aspergillus infection: two cases report and literature review

Abstract:

To summarize the clinical characteristics of pulmonary nocardiosis complicated with Aspergillus infection and improve the diagnosis and treatment of this disease. Two cases of pulmonary nocardiosis complicated with Aspergillus infection were reported. With the combination of "Nocardia" and "Aspergillus" as the key words, 6 Chinese literatures were retrieved from Wanfang Database and China National Knowledge Infrastructure; 17 foreign literatures were retrieved from PubMed and Web of Science with "nocardiosis" and "aspergillosis". Combined with the previously reported literatures and 2 patients in this report, a total of 27 cases (15 males and 12 females) were analyzed, besides 1 patient after a near-drowning incident, 23 patients had immune impairment and the rest 3 patients had underlying structural pulmonary diseases. Their clinical characteristics and imaging manifestations were nonspecific. After failure in initial anti-infection, pathogenic evidence was obtained timely, most patients had good prognosis after treatment against pulmonary nocardiosis and Aspergillosis. Pulmonary nocardiosis may be associated with Aspergillus infection, which is prone to occur in patients with immune impairment or structural pulmonary diseases, especially among glucocorticoid users. Rapid pathogenic detection to obtain early diagnosis and treatment is of great importance to improve prognosis.