Clinical characteristics of 10 patients with nocardiosis in Gansu Province

Abstract:

Objective To analyze the clinical characteristics of patients with nocardiosis, and provide experience for the diagnosis and treatment of nocardiosis. Methods Clinical data of hospitalized patients with nocardiosis diagnosed in the First Hospital of Lanzhou University between January 2017 and November 2021 were analyzed retrospectively. Results A total of 10 patients with nocardiosis were admitted for treatment, 8 were males and 2 were females, with an average age of (59.1±15.4) years, 3 cases were ≥60 years old. The main occupation of patients was far-mer (n=5, 50.0%). There were 5 cases of pulmonary nocardiosis, 4 cases of cutaneous nocardiosis and 1 case of disseminated nocardiosis. Nocardia asteroides was the main pathogen (n=5). 80.0% of the patients had underlying diseases, mainly bronchiectasis (n=3) and long-term use of glucocorticoids (n=3). Patients with pulmonary nocardiosis had cough and expectoration, rales could be heard during physical examination; cutaneous nocardiosis was mainly swelling and purulent at the focus; one case of cerebral nocardiosis was disseminated infection with loss of consciousness and with central nervous involvement. C-reactive protein in patients was 72.75 (39.25-96.74) mg/L, all increased. Pulmonary CT examination showed small nodule shadow and patch shadow (n=6), multiple cord shadow of both lung (n=4), large ground-glass shadow (n=3) and pleural effusion (n=3). After active anti-infective treatment, 9 patients got well and were discharged, one patient gave up treatment due to aggravation of disease. Conclusion For the middle-aged and elderly people with underlying pulmonary diseases and poor resistance, Nocardia infection should be considered when the effect of routine anti-infective treatment is poor, and the key is to actively perform pathogenic detection.