Nocardiosis after bone marrow transplantation: A retrospective study Journal Article


Authors: van Burik, J. A.; Hackman, R. C.; Nadeem, S. Q.; Hiemenz, J. W.; White, M. H.; Flowers, M. E. D.; Bowden, R. A.
Article Title: Nocardiosis after bone marrow transplantation: A retrospective study
Abstract: To evaluate the spectrum of nocardiosis after marrow transplantation, we reviewed the medical records of 27 patients with nocardiosis who were treated at three centers, and we reviewed the findings of three cases reported in the literature. Nocardial involvement was defined as invasive nocardiosis (n = 25), colonization (n = 4), or contamination (n = 1). The median time to the diagnosis of nocardiosis after marrow transplantation was 210 days. Nocardia asteroides complex accounted for 96% of isolates. All 25 invasive infections occurred in allogeneic marrow recipients. Ten (40%) of 25 patients with invasive nocardiosis were receiving double-strength oral trimethoprim-sulfamethoxazole twice weekly as prophylaxis for Pneumocystis carinii pneumonia. Treatment regimens for nocardiosis included sulfonamides; synergistic agents were also often added, The overall survival rate at 6 years was 34%; survival from the infection itself was 84%. Two of four nocardiosis-related deaths also involved other pathogens. The incidence of nocardiosis among allogeneic marrow recipients averaged 0.3% over 25 years. We conclude that nocardiosis is a rare infection that occurs later after marrow transplantation than other infections and that is marginally associated with increased mortality among long-term survivors of allogeneic marrow transplantation.
Keywords: neutrophils; therapy; patient; united-states; recipients; neoplastic disease; brasiliensis infection; asteroides infection; cat-scratch; farcinica
Journal Title: Clinical Infectious Diseases
Volume: 24
Issue: 6
ISSN: 1058-4838
Publisher: Oxford University Press  
Date Published: 1997-06-01
Start Page: 1154
End Page: 1160
Language: English
ACCESSION: WOS:A1997XE36600020
DOI: 10.1086/513654
PROVIDER: wos
Notes: Article; Proceedings Paper -- Presented in part at the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held 1995 Sep 17-22 in San Francisco, CA -- Source: Wos
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  1. Mary H White
    43 White