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Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing

Nocardiosis is a rare but life-threatening infection particularly affecting immuno-compromised hosts, causing localized or systemic suppurative disease usually in human beings. Nocardia species, as the pathogen of nocardiosis, are difficult to differentiate because of their complex colony morphologi...

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Autores principales: Liu, Anqing, Liu, Xiaojin, Lu, Yunwei, Gao, Zhan, Tang, Ruixiang, Huang, Yang, Zheng, Liheng, Fan, Zhenxin, He, Miao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601747/
https://www.ncbi.nlm.nih.gov/pubmed/36310857
http://dx.doi.org/10.3389/fcimb.2022.1032669
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author Liu, Anqing
Liu, Xiaojin
Lu, Yunwei
Gao, Zhan
Tang, Ruixiang
Huang, Yang
Zheng, Liheng
Fan, Zhenxin
He, Miao
author_facet Liu, Anqing
Liu, Xiaojin
Lu, Yunwei
Gao, Zhan
Tang, Ruixiang
Huang, Yang
Zheng, Liheng
Fan, Zhenxin
He, Miao
author_sort Liu, Anqing
collection PubMed
description Nocardiosis is a rare but life-threatening infection particularly affecting immuno-compromised hosts, causing localized or systemic suppurative disease usually in human beings. Nocardia species, as the pathogen of nocardiosis, are difficult to differentiate because of their complex colony morphological features. In this study, we describe two patients who had been misdiagnosed for a long time infected with Nocardia cyriacigeorgica with completely different morphology were accurately diagnosed. Single colonies were analyzed by Gram staining, acid-fast stain, mass spectrometry and whole genome resequencing (WGRS). These two bacterial, strains L5.53 and L5.54, were found to be Gram-negative and acid-fast-weak positive. Blood sample culturing of strain L5.53 yielded white colonies, which were like a layer of hoarfrost, while colonies of L5.54 were yellow, rough, slightly convex. The two strains were identified as Nocardia sp. by mass spectrometry, and WGRS accurately determined them as N. cyriacigeorgica. After medical treatment, one patient was cured and the other was still receiving treatment in the hospital. It can be seen that Nocardia sp. cannot be accurately classified and identified only by phenotypic tests such as bacterial morphological differences, so it is necessary to identify Nocardia spp. with phenotypic tests in combination with other molecular biology technologies, such as WGRS.
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spelling pubmed-96017472022-10-27 Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing Liu, Anqing Liu, Xiaojin Lu, Yunwei Gao, Zhan Tang, Ruixiang Huang, Yang Zheng, Liheng Fan, Zhenxin He, Miao Front Cell Infect Microbiol Cellular and Infection Microbiology Nocardiosis is a rare but life-threatening infection particularly affecting immuno-compromised hosts, causing localized or systemic suppurative disease usually in human beings. Nocardia species, as the pathogen of nocardiosis, are difficult to differentiate because of their complex colony morphological features. In this study, we describe two patients who had been misdiagnosed for a long time infected with Nocardia cyriacigeorgica with completely different morphology were accurately diagnosed. Single colonies were analyzed by Gram staining, acid-fast stain, mass spectrometry and whole genome resequencing (WGRS). These two bacterial, strains L5.53 and L5.54, were found to be Gram-negative and acid-fast-weak positive. Blood sample culturing of strain L5.53 yielded white colonies, which were like a layer of hoarfrost, while colonies of L5.54 were yellow, rough, slightly convex. The two strains were identified as Nocardia sp. by mass spectrometry, and WGRS accurately determined them as N. cyriacigeorgica. After medical treatment, one patient was cured and the other was still receiving treatment in the hospital. It can be seen that Nocardia sp. cannot be accurately classified and identified only by phenotypic tests such as bacterial morphological differences, so it is necessary to identify Nocardia spp. with phenotypic tests in combination with other molecular biology technologies, such as WGRS. Frontiers Media S.A. 2022-10-12 /pmc/articles/PMC9601747/ /pubmed/36310857 http://dx.doi.org/10.3389/fcimb.2022.1032669 Text en Copyright © 2022 Liu, Liu, Lu, Gao, Tang, Huang, Zheng, Fan and He https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cellular and Infection Microbiology
Liu, Anqing
Liu, Xiaojin
Lu, Yunwei
Gao, Zhan
Tang, Ruixiang
Huang, Yang
Zheng, Liheng
Fan, Zhenxin
He, Miao
Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title_full Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title_fullStr Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title_full_unstemmed Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title_short Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
title_sort two chronically misdiagnosed patients infected with nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing
topic Cellular and Infection Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601747/
https://www.ncbi.nlm.nih.gov/pubmed/36310857
http://dx.doi.org/10.3389/fcimb.2022.1032669
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