Nocardia nova causing empyema necessitatis afterlung re-transplantation: a case report.

Agueda Palmira Castagna Vargas,José De Jesus Peixoto Camargo,Luiz Carlos Severo,Flávio De Mattos Oliveira,Bruno Hochhegger,Sadi Marcelo Schio,Letícia Beatriz Matter,Cecília Bittencourt Severo

doi:10.1590/0037-8682-0331-2015

Abstract

We report herein a case of thoracic infection due to Nocardia nova following lung re-transplantation performed for emphysema related to alpha-1-antitrypsin deficiency. The infection extended from the lung into the pleural space, thoracic wall, and mediastinum, presenting as pericarditis and empyema necessitatis. Nocardia nova was identified by 16S ribosomal deoxyribonucleic acid (rDNA) sequencing and phylogenetic analysis. According to a literature search of PubMed, LILACS and MEDLINE databases, we describe herein the first case of empyema necessitatis caused by N. nova species in a transplanted patient.

Highlights

Empyema necessitatis refers to inflammatory tissue that extends directly from the pleural cavity into the thoracic wall, forming a mass in the extra-pleural soft tissues
We report a case of thoracic infection due to Nocardia nova following lung re-transplantation performed for emphysema related to alpha-1-antitrypsin deficiency.The infection extended from the lung into the pleural space, thoracic wall, and mediastinum, presenting as pericarditis and empyema necessitatis
Deoxyribonucleic acid (DNA) from isolated colonies (SBP72a/12: sampled from pleural fluid; and SBP72b/12 sampled from the pleural cavity secretion) was isolated and molecular diagnosis was performed by analyzing the partial sequence of 16S ribosomal ribonucleic acid gene amplified with universal primers(4)

Summary

Introduction

Empyema necessitatis refers to inflammatory tissue that extends directly from the pleural cavity into the thoracic wall, forming a mass (a cold abscess requiring drainage) in the extra-pleural soft tissues. Serviço de Transplante Pulmonar, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brasil. Abstract We report a case of thoracic infection due to Nocardia nova following lung re-transplantation performed for emphysema related to alpha-1-antitrypsin deficiency.The infection extended from the lung into the pleural space, thoracic wall, and mediastinum, presenting as pericarditis and empyema necessitatis. Nocardia nova was identified by 16S ribosomal deoxyribonucleic acid (rDNA) sequencing and phylogenetic analysis.

Results

Conclusion