Clinical Analysis of 34 Cases of Nocardiosis and Literature Review
Objective The clinical characteristics of Nocardiosis were analyzed and summarized to provide more experience for the diagnosis and treatment of clinical Nocardiosis and reduce misdiagnosis.Method The clinical data of 34 patients with Nocardia from January 2016 to December 2022 in Huashan Hospital affiliated with Fudan University were retrospectively analyzed.Result 17 cases had disseminated Nocardia infection,and 17 cases were infected with individual sites:9 cases were pulmonary,6 cases were skin,2 cases were muscle.Among them,26 had used immunosuppressants for underlying diseases.The general inflammatory indicators were slightly increased,and the cellular immune indicators were decreased.The disseminated infection group had less CD8+T lymphocytes,white blood cells,and C-reactive protein than the single site infection group.Imaging findings mostly showed nodules,masses and pleural effusion.Culture and sequencing are important diagnostic methods.After a definite diagnosis,most patients had a better prognosis after normal treatment,but the prognosis of some patients with intracranial infection is poor.Conclusion Nocardiosis can affect multiple systems of the body,with non-specific clinical manifestations and easy to be misdiagnosed.Patients who are middle-aged or older,use immunosuppressive medications,or have hypoimmunity should be aware that a nocardiosis infection may be the cause of a persistent fever and systemic lesions that appear as nodules or masses.Therefore,it is necessary to actively seek the etiological basis and formulate a comprehensive treatment plan combining the infection site,severity and drug sensitivity.
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