Tay, S. T. and Wong, P. L. and Chiu, C-K and Tang, S. N. and Lee, J. L. and Hamdan, N. W. and Lee, C-K and Karunakaran, R. (2021) Nocardia kroppenstedtii: A rare pathogen isolated from the spinal vertebral abscess of a patient on long-term immunosuppressive therapy. European Review for Medical and Pharmacological Sciences, 25 (2). pp. 605-608. ISSN 1128-3602, DOI https://doi.org/10.26355/eurrev_202101_24618.
Full text not available from this repository.Abstract
OBJECTIVE: Nocardia kroppenstedtii was isolated from the spinal vertebral abscess of a 78-year-old patient presenting with mid-thoracic pain and bilateral lower limb weakness and numbness. The patient was on long-term immunosuppressive therapy with steroids for underlying autoimmune hemolytic anemia. Investigations showed a T5 pathological fracture and vertebra plana with the erosion of the superior and inferior endplates. There was evidence of paraspinal collection from the T4-T6 vertebrae with an extension into the spinal canal. Analysis of Nocardia 16S rRNA (99.9%, 1395/1396 nt) and secA1 gene (99.5%, 429/431 nt) fragments showed the highest sequence similarity with Nocardia kroppenstedtii type strain (DO157924), and next with Nocardia farcinica (Z36936). The patient was treated with intravenous carbapenem and oral trimethoprim-sulfamethoxazole for four weeks, followed by another six months of oral trimethoprim-sulfamethoxazole. Despite the improvement of neurological deficits, the patient required assistive devices to ambulate at discharge. This study reports the first isolation of N. kroppenstedtii from the spinal vertebral abscess of a patient from Asia. Infections caused by N. kroppenstedtii may be underdiagnosed as the bacterium can be misidentified as N. farcinica in the absence of molecular tests in the clinical laboratory.
| Item Type: | Article |
|---|---|
| Funders: | Ministry of Energy, Science, Technology, Environment and Climate Change (MESTECC), Malaysia [Grant No: SF014-2015 & IIRG003C-19FNW ] |
| Uncontrolled Keywords: | Nocardia kroppenstedtii; Nocardia farcinica; Spinal infection; 16SrDNA; secA1 |
| Subjects: | R Medicine > RM Therapeutics. Pharmacology |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 20 Jun 2022 07:27 |
| Last Modified: | 20 Jun 2022 07:27 |
| URI: | http://eprints.um.edu.my/id/eprint/34063 |
Actions (login required)
 |
View Item |
