AUTHOR=Qiu Fulan , Ma Zhiyi , Zhong Rongrong , Huang Haonan , Wang Yuehua , Liu Hui 

TITLE=Case Report: Disseminated Nocardiosis Caused by Nocardia vulneris in a Patient With Macroglobulinemia

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.866420

DOI=10.3389/fpubh.2022.866420

ISSN=2296-2565

ABSTRACT=A case of disseminated nocardiosis caused by Nocardia vulneris in a 61-year-old man with macroglobulinemia and presenting with fever, cough, shortness of breath and muscle pain is reported herein. The isolated Nocardia strain was resistant to ciprofloxacin, but susceptible to amikacin, gentamicin, tobramycin, linezolid, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic, moxifloxacin, ceftriaxone, cefotaxim, imipenem. The patient was started on meropenem combinations with doxycycline treatment, followed by trimethoprim-sulfamethoxazole, and then  he was switched to a combination treatment of  linezolid, amikacin and trimethoprim-sulfamethoxazole. The patient recovered and his condition remained stable. Although infection by Nocardia vulneris is rare, clinicians should be aware of its diagnostic, in addition, the MIC value of the drug sensitivity test should be concerned when there is a wide choice of medicines, and the current case was treated successfully with linezolid, amikacin and trimethoprim-sulfamethoxazole. And for the disseminated cases which are diagnosed definitely should be treated with at least 12 months of antimicrobial therapy, bacteriological examination and antimicrobial susceptibility testing should be performed repeatedly.