gms | German Medical Science

126. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2009, München

Nocardiosis following solid organ transplantation: single center experience with eleven cases

Meeting Abstract

  • corresponding author T.R. Flohr - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • B. Swenson - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • C.D. Sifri - Department of Internal Medicine, University of Virginia, Charlottesville, VA, USA
  • R.G. Sawyer - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • T.L. Pruett - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • K. Brayman - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • K. Hagspiel - Department of Radiology, University of Virginia, Charlottesville, VA, USA
  • T. Hranjec - Department of Surgery, University of Virginia, Charlottesville, VA, USA
  • H.JR. Bonatti - Department of Surgery, University of Virginia, Charlottesville, VA, USA

Deutsche Gesellschaft für Chirurgie. 126. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09dgch11529

DOI: 10.3205/09dgch605, URN: urn:nbn:de:0183-09dgch6050

Published: April 23, 2009

© 2009 Flohr et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Nocardiosis is a rare opportunistic localized or disseminated infection in patients undergoing solid organ transplantation (SOT). Nocardia species are aerobic actinomyces ubiquitously found worldwide in soil rich with organic matter.

Material and methods: All diagnosed cases of Nocardia infection at our institution from 1995 to 2008 were retrieved from the microbiology database. A total of 67 patients were diagnosed with nocardiosis. Eleven cases in SOT recipients were identified.

Results: The eleven cases of nocardiosis were identified in a series of 2087 solid organ transplants performed between January 1995 and July 2007. There were six renal recipients, one pancreas/kidney, two lung and two liver recipients. Three had simultaneous infection with Nocardia spp and Aspergillus spp. Ten patients were successfully treated but one liver transplant patient died shortly after retransplantation from pulmonary nocardiosis and disseminated aspergillosis. Another five patients died during follow up unrelated to nocardiosis. The main risk factors in this cohort were use of depleting antibodies for induction or rejection and a history or current nicotine abuse.

Conclusion: Nocardiosis is a rare complication following SOT, but is, nonetheless potentially fatal. The overall incidence seems to be increasing in the transplant population. Therefore, the recognition of symptoms, diagnosis and treatment are important in this special population.