A Case of Lung Abscess Caused by Nocardia elegans in a Kidney Transplantation Recipient

Ki Ho Park; Sun-Young Ko; Ryan Oh; Tark Kim; Oh Hyun Cho; Yang Soo Kim; Jun Hee Woo; Duck Jong Han; Heungsup Sung; Mi-Na Kim

doi:10.3947/ic.2008.40.2.116

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Park, Ko, Oh, Kim, Cho, Kim, Woo, Han, Sung, and Kim: A Case of Lung Abscess Caused by Nocardia elegans in a Kidney Transplantation Recipient

Case Report

Infection and Chemotherapy

Infection and Chemotherapy 2008; 40(2): 116-120.

Published online: 20 April 2008

DOI: https://doi.org/10.3947/ic.2008.40.2.116

A Case of Lung Abscess Caused by Nocardia elegans in a Kidney Transplantation Recipient

Ki Ho Park, M.D.¹, Sun-Young Ko, M.D.², Ryan Oh, M.D.¹, Tark Kim, M.D.¹, Oh Hyun Cho, M.D.¹, Yang Soo Kim, M.D.¹, Jun Hee Woo, M.D.¹, Duck Jong Han, M.D.³, Heungsup Sung, M.D.², Mi-Na Kim, M.D.²

¹Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

²Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

³Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Heungsup Sung, M.D. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 138-736, Korea. Tel: 82-2-3010-4499, Fax: 82-2-478-0884, sung@amc.seoul.kr

Received 5 December 2007 Accepted 11 February 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nocardiosis is well-known opportunistic infection in immunocompromised patients. The timely diagnosis and treatment, however, is still a difficult problem. Recently, as newer molecular techniques, particularly 16S rRNA sequencing, are implemented, the diagnosis and management of the infection are improving. We report a case of lung abscess in a 39-year-old-man who underwent kidney transplantation. He was diagnosed of Nocardia elegans by 16S rRNA sequencing and was cured of the infection with appropriate antibiotic therapy.

Keywords: Nocardia elegans, Nocardiosis, Lung abscess

Figures and Tables

Fig. 1

(A) Initial chest radiograph showed hazy, irregular density in the RUL and a thin-walled cavitary lesion in the LUL. (B) Chest radiograph four weeks later following combination therapy with imipenem/cilastatin. The hazy density disappeared (arrow heads), and cavitary lesion decreased in size (arrow).

Fig. 2

(A) Colonial morphology of Nocardia elegans on a blood agar plate after three days of incubation. White-gray colonies with aerial hyphae have grown on the plate. (B) Modified Kinyoun stain from a blood agar plate after three days of incubation; many long-branching forms were stained positive for modified acid-fast. Some coccal forms are also present.

Figure 3

Unrooted tree showing the phylogenetic relationships of the current isolate (B472) and the closely related Nocardia species. The tree constructed using the neighbour-joining method based on a comparison of 650 nucleotides. A scale of "0.1" indicates s 0.1 nucleotide substitutions per site.

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