Updates on Nocardia Skin and Soft Tissue Infections in Solid Organ Transplantation

AbstractPurpose of ReviewDue to their immunocompromised status, solid organ transplant (SOT) recipients are at risk forNocardia infections. These infections often necessitate early invasive diagnostics alongside prolonged, often combination antimicrobial therapy. This review summarizes the importance of this pathogen in skin and soft tissue infections (SSTIs) in SOT recipients inclusive of recently reported cases in the literature and an update on the epidemiology, diagnostics, and management.Recent FindingsSix studies with 13 isolated SSTIs due toNocardia have been published in the last 5  years in SOT recipients. The most common underlying type of transplant was kidney and time from transplantation to infection varied from 6 months to 16 years. Misdiagnosis was frequent. Available identified species includedN. brasiliensis (2),N. farcinica (2),N. flavorosea (1),N. abscessus (1),N. anaemiae (1),N. asteroides (1),N. nova (1), andN. vinacea (1). Treatment choice and duration varied widely, and trimethoprim-sulfamethoxazole was utilized most often with no documented infection relapse.SummaryNocardia SSTIs can occur both in isolation and as a component of a disseminated infection. Overall, isolatedNocardia SSTIs are uncommon in SOT recipients and are often initially misdiagnosed. They present multiple challenges to the clinician including evaluation for potential co-pathogens and/or non-infectious processes and ruling out the presence of disseminated infection. While trimetho...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research