Τίτλος:
Pulmonary nocardiosis in an immunocompetent patient with COPD: The role of defective innate response
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: Pulmonary nocardiosis is an uncommon opportunistic infection affecting mainly immunocompromised patients. We herein present a case of nocardiosis without profound underlying immunodeficiency. Background: A female, 84-years' old patient with stage IV chronic obstructive pulmonary disease (COPD) is presented. No profound causes of immunodeficiency existed, such as HIV infection, diabetes mellitus, malignancy, alcoholism, chemotherapy or previous corticosteroid intake. The patient recovered after treatment with trimethoprim/sulfamethoxazole for 6 months. Results: One year after infection resolution, stimulation of the patient's blood monocytes with Nocardia antigens revealed defective production of tumor necrosis factor-alpha, interleukin (IL)-6 and IL-17. Conclusion: We provide preliminary evidence for a link between defective innate immune responses and predisposition for Nocardia infections. Further studies must be conducted in order to fully investigate this mechanism of infection acquisition. © 2013 Elsevier Inc.
Συγγραφείς:
Kontogiorgi, M.
Opsimoulis, P.
Kopterides, P.
Savva, A.
Kalodimou, V.E.
Belesiotou, E.
Giamarellos-Bourboulis, E.
Περιοδικό:
Heart and Lung: Journal of Acute and Critical Care
Λέξεις-κλειδιά:
C reactive protein; ceftazidime; ciprofloxacin; cotrimoxazole; diatrizoate; interleukin 17; interleukin 6; ipratropium bromide plus salbutamol sulfate; linezolid; trypan blue; tumor necrosis factor alpha, aged; alcoholism; arterial gas; article; blood culture; blood sampling; case report; Caucasian; chronic obstructive lung disease; chronic respiratory failure; clinical practice; computer assisted tomography; coronary artery disease; coughing; day hospital; diabetes mellitus; disease exacerbation; dyspnea; enzyme immunoassay; erythrocyte sedimentation rate; female; fever; fiberoptic bronchoscopy; HIV test; hospital admission; hospital discharge; human; Human immunodeficiency virus infection; hypothyroidism; hypoxemia; immunocompromised patient; innate immunity; laboratory test; leukocytosis; limit of detection; lung lavage; lung lesion; lymphocyte; medical history; mental health; monocyte; neutrophil; Nocardia asteroides; nocardiosis; oxygen therapy; peripheral blood mononuclear cell; personal experience; priority journal; pulmonary nocardiosis; respiratory function; serology; sputum culture; supernatant; sweat; thorax pain; thorax radiography; treatment duration, COPD; IL-17; IL-6; Nocardiosis; TNFα, Aged, 80 and over; Female; Humans; Immunity, Innate; Immunocompetence; Interleukin-17; Interleukin-6; Lung; Nocardia; Nocardia Infections; Opportunistic Infections; Pulmonary Disease, Chronic Obstructive; Tumor Necrosis Factor-alpha
DOI:
10.1016/j.hrtlng.2013.03.007
