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Research article
Habib Ahmad
French Medical Institute for mother and Children
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Pulmonary nocardiosis is a rare disease. It usually affects immunocompromised patients. In this study we evaluated our clinical experience with pulmonary nocardiosis in our centre.
Method
It was a retrospective study done in Aga Khan University Hospital. Study was started after ethical approval. Cases from 2007 to 2017 were retrieved. Patient with diagnosis of Culture positive Pulmonary Nocardiosis with age more than 18 years included. Patient who were already on treatment of Nocardiosis at time of admission were excluded. Patients’ medical records were reviewed to identify epidemiologic, clinical, microbiologic, and radiographic features. Data was entered on SPSS V22.
Results
56 patient met inclusion criteria but 12 had missing data so 44 patients’ data was included at end. 8 patients had disseminated disease. 52% were immunocompromised and 48% were immunocompetent. 31 were females. Diabetes mellitus was most common comorbidity. Fever and shortness of breath were most common presentations. Pleural effusion and consolidation were most common chest xray findings. Mean white cell count was 12.35±7 ×109/L. 70% patient had some degree of hyponatremia. Culture showed that all strains were sensitive to amikacin and 67% were sensitive to imipenum. Mean length of stay was 7.7days. 30 day mortality was 23%. 16% required ICU stay. There was significant difference between immunocompromized and immunocompetent group regarding 30 day mortality (p value 0.019) and ICU admission need (p value 0.021).
Conclusion
Pulmonary nocardiosis is often missed, high index of suspicion is required especially in immunocompromised patients and mortality is often very high.
Keywords
Nocardiosis, Pulmonary nocardiosis, Pneumonia
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Habib Ahmad
French Medical Institute for mother and Children
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Jun, 2019
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Pulmonary nocardiosis is a rare disease. It usually affects immunocompromised patients. In this study we evaluated our clinical experience with pulmonary nocardiosis in our centre.
Method
It was a retrospective study done in Aga Khan University Hospital. Study was started after ethical approval. Cases from 2007 to 2017 were retrieved. Patient with diagnosis of Culture positive Pulmonary Nocardiosis with age more than 18 years included. Patient who were already on treatment of Nocardiosis at time of admission were excluded. Patients’ medical records were reviewed to identify epidemiologic, clinical, microbiologic, and radiographic features. Data was entered on SPSS V22.
Results
56 patient met inclusion criteria but 12 had missing data so 44 patients’ data was included at end. 8 patients had disseminated disease. 52% were immunocompromised and 48% were immunocompetent. 31 were females. Diabetes mellitus was most common comorbidity. Fever and shortness of breath were most common presentations. Pleural effusion and consolidation were most common chest xray findings. Mean white cell count was 12.35±7 ×109/L. 70% patient had some degree of hyponatremia. Culture showed that all strains were sensitive to amikacin and 67% were sensitive to imipenum. Mean length of stay was 7.7days. 30 day mortality was 23%. 16% required ICU stay. There was significant difference between immunocompromized and immunocompetent group regarding 30 day mortality (p value 0.019) and ICU admission need (p value 0.021).
Conclusion
Pulmonary nocardiosis is often missed, high index of suspicion is required especially in immunocompromised patients and mortality is often very high.
Figure 1
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