Analysis of clinical features of Nocardia infection with suspected pulmonary tuberculosis
Objective To investigate the clinical characteristics of Nocardia infection in patients with suspected pulmonary tuberculosis,and to improve the diagnosis of Nocardia pulmonary disease.Methods A total of 115 patients with Nocardia infection and suspected pulmonary tuberculosis admitted to Guangzhou Chest Hospital from January 2020 to December 2023 were retrospectively selected as the study objects.There were 57 males and 58 females,aged 16-88(50.26±17.26)years.According to the combination of pulmonary tuberculosis and non-tuberculous mycobacterium lung disease,75 cases of pulmonary tuberculosis with Nocardia infection were classified as group A,17 cases of non-tuberculous mycobacterium lung disease with Nocardia infection were classified as group B,and 23 cases of Nocardia infection alone were classified as group C.The CT imaging features of lung lesions and the occurrence of main suspected symptoms of pulmonary tuberculosis(cough,expectoration,hemoptysis,fever,shortness of breath,chest tightness,and chest pain)in the three groups were compared and analyzed.x2 test,independent sample t test,and rank sum test were used.Results The detection time of Nocardia in group A was 4(2,8)months after anti-tuberculosis treatment,and the detection time of Nocardia in group B was 10(2,12)months after anti-nontuberculous mycobacterium treatment.Among the isolates,there were 113 strains of Nocardia farcinica,1 strain of Nocardia pseudobrasiliensis,and 1 strain of Nocardia Africa/nova.CT images of the three groups showed lung consolidation,plaques,nodules,strips or hollow shadows,it was difficult to distinguish pulmonary tuberculosis,non-tuberculous mycobacterium lung disease,and Nocardia pulmonary infection.Anatomical sites involved:the incidences of multiple lobes involved in both lungs in group A,B,and C were 66.67％(50/75),94.12％(16/17),and 69.57％(16/23),respectively,the incidence in group B was higher than that in group A(x2=5.150,P=0.020),but there was no statistically significant difference between group A and group C or between group B and group C(x2=0.067,P=0.796;x2=3.683,P=0.055).There was no statistically significant difference in the incidence of suspected symptoms of pulmonary tuberculosis among the three groups(x2=2.650,P=0.998).Conclusion Nocardia infection is common in patients with pulmonary tuberculosis and non-tuberculous mycobacterium lung disease,but the clinical manifestations and imaging examination are difficult to distinguish,which should be paid enough attention to in clinical practice.
万方数据
维普
