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Vol. 44. Issue 2.
Pages 109-112 (January 2008)
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Vol. 44. Issue 2.
Pages 109-112 (January 2008)
Case Reports
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Isolation of Nocardia Species in Patients With Cystic Fibrosis
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5562
M. Isabel Barrioa,
Corresponding author
mbarrio.hulp@salud.madrid.org

Correspondence: Dra MI Barrio Sección de Neumología Pediátrica, Hospital Infantil La PazP.º de la Castellana, 261 28046 Madrid, Spain
, M. Carmen Martíneza, Concepción Pradosb, Rosa M. Girónc, Luis Maizd, M. Teresa Martíneze, the Cystic Fibrosis Group of the Society of Pulmonology and Thoracic Surgery of Madrid (Neumomadrid)
a Sección de Neumología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
c Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
d Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain
e Servicio de Neumología, Hospital 12 de Octubre, Madrid, Spain
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The isolation of Nocardia species from the respiratory secretions of patients with cystic fibrosis presents problems with important clinical implications. From the sputum culture of a total of 387 patients with cystic fibrosis, Nocardia species was isolated in 9 cases (2%; 8 females and 1 male) with a mean (SD) age of 17 (7) years. Sixty-seven percent of the patients were asymptomatic and no relevant radiographic or analytical changes were detected. In only 3 patients was Nocardia species isolated again in successive samples. Two patients were not treated, 7 were treated with cotrimoxazole and 3 with minocycline; in 2 cases therapy was intravenous. After a mean follow-up of 48 (33) months, all patients had improved. Isolation of Nocardia species from the secretions of patients with cystic fibrosis does not necessarily imply infection and the need for treatment should be assessed on an individual basis.

Key words:
Cystic fibrosis
Nocardia species
Nocardiosis

El aislamiento de Nocardia spp. en las secreciones respiratorias de los pacientes con fibrosis quística (FQ) plantea problemas en cuanto a su trascendencia clínica. De un total de 387 pacientes con FQ, se aisló Nocardia spp. en el cultivo de esputo en 9 (2%; 8 mujeres y un varón), con una edad media (± desviación estándar) de 17 ± 7 años. El 67% de los casos se encontraba asintomático y en ningún paciente se detectaron cambios radiológicos ni analíticos de interés. En sólo 3 pacientes el aislamiento se repitió en muestras sucesiva. Dos pacientes no fueron tratados y en los restantes se empleó cotrimoxazol (7 casos), minociclina (3 casos) y tratamiento intravenoso (2 casos). Después de un seguimiento de 48 ± 33 meses, todos los pacientes presentaron una evolución clínica favorable. El aislamiento de Nocardia spp. en pacientes con FQ no implica necesariamente infección y la necesidad de tratamiento debe valorarse individualmente.

Palabras clave:
Fibrosis quística
Nocardia
Nocardiosis
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