TABLE 1.
Main characteristics of the study population (n = 68)
Characteristica | Finding |
---|---|
Age at diagnosis (median [range]) (yr) | 54 (5–89) |
Male (n [%]) | 42 (61.7) |
Underlying conditions for nocardiosis (n [%])b | |
Corticosteroid | 27 (39.7) |
Immunosuppressive treatment | 27 (39.7) |
Chronic bronchopulmonary disease or asthma | 27 (39.7) |
Solid organ transplantation | 14 (20.5) |
Allogeneic HSCT | 14 (20.5) |
Primary immunodeficiencyc | 9 (13.2) |
HIV infection | 7 (10.2) |
Autologous HSCT | 4 (5.8) |
Comorbidities (n [%]) | |
Diabetes mellitus (n = 66) | 10 (15.1) |
Neutropenia (n = 64)d | 2 (3.1) |
SXT prophylaxis (n [%]) | 25 (36.7) |
Type of clinical sample for Nocardia PCR testing (n [%]) | |
Respiratory samples | |
BAL fluid sample | 40 (58.8) |
Bronchial sampling specimen | 7 (10.2) |
Sputum sample | 6 (8.8) |
Lung biopsy specimen | 2 (2.9) |
Other specimens | |
Abscess specimen | 5 (7.3) |
Cutaneous biopsy specimen | 3 (4.4) |
Pleural fluid sample | 2 (2.9) |
CSF sample | 2 (2.9) |
Lymph node specimen | 1 (1.4) |
PCR result (n [%]) | |
Positive | 32 |
Positive for N. farcinica | 14 (43.7) |
Clinical/radiological presentation (n [%]) | |
Pulmonary | 61 (89.7) |
Disseminated disease | 15 (22) |
Cutaneous or muscular | 10 (14.7) |
Cerebral | 6 (8.8) |
Deep-seated abscess | 4 (5.8) |
Othere | 8 (11.7) |
Duration of symptoms before sampling (median [range]) (days) (n = 57) | 30 (1–730) |
Outcome of death at 6 mo (n [%]) (n = 67) | 10 (14.7) |
BAL, bronchoalveolar lavage; CSF, cerebrospinal fluid; HIV, human immunodeficiency virus; HSCT, hematopoietic stem cell transplantation; SXT, trimethoprim-sulfamethoxazole.
Each patient could have several underlying conditions.
Primary immunodeficiencies included chronic granulomatous disease (n = 3), defect of the interleukin-12 (IL-12) axis (n = 2), severe combined immunodeficiency (n = 2), lymphohistiocytosis (n = 1), and X-linked agammaglobulinemia (n = 1).
Defined as polymorphonuclear cell counts of <500 cells/mm3.
Other includes lymph node (n = 4), bone (n = 2), blood (n = 1), eye (n = 1), and liver (n = 1) involvement.