Analysis of clinical characteristics of 11 patients with Nocardia infection
Objective To analyze the clinical characteristics of patients with Noc ardia infection,and to provide references for the diagnosis and treatment of nocardiosis.Methods The clinical data of patients diagnosed with Noc ardia infection in our hospital from September 2018 to July 2023 were retrospectively collected and analyzed.Results Among the 11 patients with Noc ardia infection,6 were male and 5 were female.The mean age was(67.0±12.0)years;the average hospital stay was(13.3±10.8)d.All patients were accompanied by underlying diseases,combined with cardiovascular and cerebrovascular diseases(72.7%),chronic lung diseases(45.5%)and hypoproteinemia(45.5%).Eleven patients with Noc ardia infection had clinical features such as fever(63.6%),cough and expectoration(54.5%),chest tightness,shortness of breath,chest pain and fatigue(both 27.3%).Chest imaging examination showed patchy density shadow(72.7%),nodular,cord-like density shadow,pleural effusion(both 27.3%)and other characteristics.Laboratory tests showed that white blood cell count(WBC)(45.5%),neutrophil(N)ratio(90.9%)and C-reactive protein(CRP),procalcitonin(PCT)(both 63.6%)levels increased,and albumin(ALB)level(72.7%)decreased.Among the 11 strains,6 strains of Noc ardia(54.5%),3 strains of Nocardia st.George(27.3%),1 strain of Nocardia caviae otitis media and 1 strain of Nocardia neodiarrhea were identified(both 9.1%).Eight patients were treated with trimethoprim-sulfamethoxazole(TMP-SMZ)alone or in combination;two patients were treated with cefoperazone/sulbactam alone.A total of 9 cases improved(81.8%),1 case abandoned(9.1%),and 1 case died(9.1%).Conclusion The clinical manifestations of Noc ardia infection are lack of specificity and easy to be misdiagnosed.Early etiological detection is helpful for the diagnosis and treatment of nocardiosis.TMP-SMZ can be used as the preferred drug for the treatment of Noc ardia,single or combined treatment has a good prognosis for patients.
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