©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2022; 10(28): 10120-10129
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10120
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10120
Successful treatment of disseminated nocardiosis diagnosed by metagenomic next-generation sequencing: A case report and review of literature
Ting Li, Yi-Xin Chen, Jia-Jia Lin, Wei-Xian Lin, Wei-Zhen Zhang, Hang-Ming Dong, Shao-Xi Cai, Ying Meng, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: Meng Y provided this case; Li T and Chen TX wrote the manuscript; Lin JJ, Lin WX and Zhang WZ contributed significantly to manuscript preparation; Dong HM and Cai SX helped perform the analysis and contributed to constructive discussions; all authors have read and approved the final version.
Supported by the Project of Nanfang Hospital President Foundation of Southern Medical University , No. 2019C006 .
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that there is no conflict of interest. The patient agreed with the case report.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ying Meng, Doctor, Chief Doctor, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Baiyun District, Guangzhou 510515, Guangdong Province, China. nfyymengy@163.com
Received: January 25, 2022
Peer-review started: January 25, 2022
First decision: March 23, 2022
Revised: March 25, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: October 6, 2022
Processing time: 245 Days and 0.3 Hours
Peer-review started: January 25, 2022
First decision: March 23, 2022
Revised: March 25, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: October 6, 2022
Processing time: 245 Days and 0.3 Hours
Core Tip
Core Tip: Early detection of Nocardia paucivorans can optimize antibiotic management, shorten hospital stays and improve survival rates. We report rapid detection of N. paucivorans by metagenomic next-generation sequencing (mNGS) of BALF. The patient was treated with trimethoprim-sulfamethoxazole (TMP-SMZ) and linezolid by individual dose adjustment based on serum concentration and thrombocytopenia and leukopenia, then replaced by TMP-SMZ and ceftriaxone or minocycline. This case suggests that mNGS is a convenient and efficient technique for detecting Nocardia, especially suitable for rare, novel and atypical etiologies of complicated infectious diseases. Linezolid may be an important alternative in disseminated nocardiosis.