{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T06:34:15Z","timestamp":1769322855905,"version":"3.49.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze and summarize the clinical characteristics, treatments, and prognosis of Cushing\u2019s syndrome (CS) with nocardiosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A patient in our hospital and additional 17 patients of CS with nocardiosis in the English literature were included in this study. Clinical characteristics, laboratory data, imaging studies, treatments, and prognosis were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 41-year-old man with CS was diagnosed and treated in our hospital. He had co-infections of nocardiosis and aspergillosis. Together with 17 patients of CS with nocardiosis in the English literature, 2 patients (11.1%) were diagnosed as Cushing\u2019s disease (CD) while 16 (88.9%) were diagnosed or suspected as ectopic ACTH syndrome (EAS). The average 24hrUFC was 7,587.1 \u00b1 2,772.0 \u03bcg\/d. The average serum total cortisol and ACTH (8 AM) was 80.2 \u00b1 18.7 \u03bcg\/dl and 441.8 \u00b1 131.8 pg\/ml, respectively. The most common pulmonary radiologic findings in CT scan were cavitary lesions (10\/18) and nodules (8\/18). Co-infections were found in 33.3% (6\/18) patients. The CS patients with co-infections had higher levels of ACTH (671.5 \u00b1 398.2 <jats:italic>vs<\/jats:italic> 245.5 \u00b1 217.1 pg\/ml, <jats:italic>P<\/jats:italic> = 0.047), and 38.9% (7\/18) patients survived through the antibiotic therapy and the treatment of CS. Patients with lower level of ACTH (survival <jats:italic>vs<\/jats:italic> mortality: 213.1 \u00b1 159.0 <jats:italic>vs<\/jats:italic> 554.7 \u00b1 401.0 pg\/ml, P = 0.04), no co-infection, underwent CS surgery, and received antibiotic therapy for more than 6 months, had more possibilities to survive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nocardia infection should be cautioned when a patient of CS presented with abnormal chest radiographs. The mortality risk factors for CS with nocardiosis are high level of ACTH and co-infections. We should endeavor to make early etiological diagnosis, apply long-term sensitive antibiotics and aggressive treatments of CS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.640998","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T17:17:03Z","timestamp":1617038223000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Cushing\u2019s Syndrome With Nocardiosis: A Case Report and a Systematic Review of the 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