Abstract
Nocardiosis is primarily an opportunistic infection affecting immunosuppressed individuals, in whom it most commonly presents as pulmonary infection and sometimes cerebral abscesses. Isolated abdominal or retroperitoneal nocardiosis is rare. Here, we report the second case, to our knowledge, of isolated abdominal nocardiosis due to Nocardia paucivorans and provide a comprehensive review of intra-abdominal nocardiosis. The acquisition of abdominal nocardiosis is believed to occur via hematogenous spreading after pulmonary or percutaneous inoculation or possibly via direct abdominal inoculation. Cases of Nocardia peritonitis have been reported in patients on peritoneal dialysis. Accurate diagnosis of abdominal nocardiosis requires histological and/or microbiological examination of appropriate, radiologically or surgically obtained biopsy specimens. Malignancy may initially be suspected when the patient presents with an abdominal mass. Successful therapy usually includes either percutaneous or surgical abscess drainage plus prolonged combination antimicrobial therapy.
Highlights
Nocardia are gram-positive, aerobic, filamentous bacteria that most often cause pulmonary infection in immunosuppressed hosts, while isolated abdominal or retroperitoneal nocardiosis is rare [1]
We provide a comprehensive review of the literature, summarizing the information on 39 previously published cases of intra-abdominal and retroperitoneal nocardiosis and 12 cases of peritoneal dialysis-related nocardia peritonitis [2,5,6,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]
There is one case of abdominal/retroperitoneal N. paucivorans infection in the literature, a 63-year old lung transplant recipient with a renal abscess published by Roy in 2018 [2]
Summary
Nocardia are gram-positive, aerobic, filamentous bacteria that most often cause pulmonary infection in immunosuppressed hosts, while isolated abdominal or retroperitoneal nocardiosis is rare [1]. We report the second case, to our knowledge, of isolated abdominal nocardiosis due to Nocardia paucivorans. We will review published cases of infection with Nocardia paucivorans, a rare nocardial species
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