{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:38:58Z","timestamp":1792517938091,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Nocardia is an anthropozoonotic bacteria that occurs widely in the natural environment. However, because it is a gram-positive aerobic opportunistic pathogen, it rarely occurs in patients with no prior history of immune function disease. Since the symptoms are nonspecific the diagnosis of Nocardia pneumonia is challenging. Previous studies have not reported that this anthropozoonotic bacteria colonizing the human body could cause severe pneumonia by gingival pain and pharyngeal discomfort. This case report describes a previously healthy 60-year-old female farmer who presented to the doctor with gingival pain and pharyngeal discomfort. She was treated with a dental cleaning and oral metronidazole. The patient rapidly progressed to breathing difficulties. Lung shadow was found by computerized tomography examination. The radiologist diagnosed pulmonary tuberculosis as image-based. Through laboratory examination and culture of pathogenic microorganisms in the sputum and blood of the patient, no obvious positive findings were found. The disease progressed rapidly to tracheal intubation ventilator assisted breathing. Subsequently, the patient underwent alveolar lavatory examination under endotracheal intubation fiberbronchoscopy, and the culture of alveolar lavage fluid indicated Nocardia. According to this result, the patient\u2019s disease was quickly controlled after selecting the targeted drug compound sulfamethoxazole and intravenous meropenem for treatment. In view of the reason for the high misdiagnosis rate due to the low positive rate of Nocardia culture in most cases, the clinical thinking of diagnosis and treatment from oral infection symptoms to fatal pneumonia reported in this case has certain clinical popularization and enlighten significance, not only improved the diagnosis and treatment of rare diseases, but also be reduced medical disputes.<\/jats:p>","DOI":"10.3389\/fmed.2024.1424564","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T04:26:27Z","timestamp":1721190387000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case report: From oral infection to life-threatening pneumonia: clinical considerations in Nocardia infection from a case"],"prefix":"10.3389","volume":"11","author":[{"given":"Kang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Shang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Ping","family":"Ai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"7447","DOI":"10.2147\/IDR.S441117","article-title":"Abdominal abscesses caused by Nocardia farcinica in an immunocompromised patient: a case report and literature review","volume":"16","author":"Wang","year":"2023","journal-title":"Infect Drug Resist."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.chest.2023.07.067","article-title":"Pulmonary Nocardiosis with Endobronchial involvement caused by Nocardiaaraoensis","volume":"165","author":"Tajima","year":"2024","journal-title":"Chest"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3389\/fcimb.2020.00013","article-title":"Rapid detection of Nocardia by next-generation sequencing","volume":"10","author":"Weng","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"102806","DOI":"10.1016\/j.bjid.2023.102806","article-title":"Nocardiosis: a single-center experience and literature review","volume":"27","author":"Besteiro","year":"2023","journal-title":"Braz J Infect Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e00458","DOI":"10.1002\/rcr2.458","article-title":"Pulmonary nocardiosis caused by Nocardia exalbida mimicking lung cancer","volume":"7","author":"Miyamoto","year":"2019","journal-title":"Respirol Case Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3892\/etm.2014.1715","article-title":"Clinical findings of 40 patients with nocardiosis: a retrospective analysis in a tertiary hospital","volume":"8","author":"Yang","year":"2014","journal-title":"Exp Ther Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"357","DOI":"10.18295\/squmj.9.2021.131","article-title":"The findings of pulmonary Nocardiosis on chest high resolution computed tomography: single Centre experience and review of literature","volume":"22","author":"Al Umairi","year":"2022","journal-title":"Sultan Qaboos Univ Med J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.17219\/acem\/175818","article-title":"Central nervous system nocardiosis diagnosed by metagenomic next-generation sequencing: a case series and literature review","volume":"32","author":"Yuan","year":"2023","journal-title":"Adv Clin Exp Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0156021","DOI":"10.1128\/spectrum.01560-21","article-title":"Epidemiology and antimicrobial resistance profiles of the Nocardia species in China, 2009 to 2021","volume":"10","author":"Wang","year":"2022","journal-title":"Microbiol Spectr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0027423","DOI":"10.1128\/iai.00274-23","article-title":"Candida auris-macrophage cellular interactions and transcriptional response","volume":"91","author":"Miram\u00f3n","year":"2023","journal-title":"Infect Immun"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1080\/20009666.2021.1877399","article-title":"Brain metastasis or nocardiosis? A case report of central nervous system Nocardiosis with a review of the literature","volume":"11","author":"Sun","year":"2021","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"444","DOI":"10.3201\/eid2902.221389","article-title":"Nocardia neocaledoniensis as rare cause of spondylodiscitis","volume":"29","author":"Choquet","year":"2023","journal-title":"Emerg Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/s00203-022-02878-x","article-title":"Nocardia noduli sp. nov., a novel actinobacterium with biotechnological potential","volume":"204","author":"Nouioui","year":"2022","journal-title":"Arch Microbiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1186\/s12879-023-08615-z","article-title":"Clinical characteristics of hospitalized patients with Nocardia genus detection by metagenomic next generation sequencing in a tertiary hospital from southern China","volume":"23","author":"Liang","year":"2023","journal-title":"BMC Infect Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e01022","DOI":"10.1128\/MRA.01022-20","article-title":"Complete genome sequence of multidrug-resistant strain Nocardia wallacei FMUON74, isolated from a sputum culture","volume":"9","author":"Toyokawa","year":"2020","journal-title":"Microbiol Resour Announc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1128\/CMR.7.3.357","article-title":"The medically important aerobic actinomycetes: epidemiology and microbiology","volume":"7","author":"McNeil","year":"1994","journal-title":"Clin Microbiol Rev"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s12890-023-02434-3","article-title":"Co-infection with Mycobacterium tuberculosis and Nocardia farcinica in a COPD patient: a case report","volume":"23","author":"Chen","year":"2023","journal-title":"BMC Pulm Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1590\/s0036-46652014000500005","article-title":"Differentiation between Nocardia spp. and Mycobacterium spp.: critical aspects for bacteriological diagnosis","volume":"56","author":"Muricy","year":"2014","journal-title":"Rev Inst Med Trop S\u00e3o Paulo"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1111\/resp.13831","article-title":"Pulmonary alveolar proteinosis","volume":"25","author":"Jouneau","year":"2020","journal-title":"Respirology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"4601","DOI":"10.2147\/IDR.S249761","article-title":"Invasive Nocardiosis: disease presentation, diagnosis and treatment - old questions, new answers?","volume":"13","author":"Lafont","year":"2020","journal-title":"Infect Drug Resist"},{"key":"ref21","first-page":"7501","article-title":"Clinical characteristics and prognosis of COVID-19 patients with initial presentation of lung lesions confined to a single pulmonary lobe","volume":"12","author":"Zhu","year":"2020","journal-title":"Am J Transl Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1186\/s12879-023-08522-3","article-title":"Comparative study of diagnostic efficacy of sputum and bronchoalveolar lavage fluid specimens in community-acquired pneumonia children treated with fiberoptic bronchoscopy","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Infect Dis"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"491","DOI":"10.2147\/RMHP.S361081","article-title":"Neglected foreign body aspiration mimicking lung Cancer recurrence","volume":"15","author":"Li","year":"2022","journal-title":"Risk Manag Healthc Policy"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"5226","DOI":"10.1099\/ijsem.0.004398","article-title":"Nocardia macrotermitis sp. nov. and Nocardia aurantia sp. nov., isolated from the gut of the fungus-growing termite Macrotermes natalensis","volume":"70","author":"Benndorf","year":"2020","journal-title":"Int J Syst Evol Microbiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12883-015-0437-7","article-title":"HIV\/AIDS presenting with stroke-like features caused by cerebral Nocardia abscesses: a case report","volume":"15","author":"Stefaniak","year":"2015","journal-title":"BMC Neurol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ijid.2017.01.005","article-title":"Nocardiosis in the south of France over a 10-years period, 2004-2014","volume":"57","author":"Haussaire","year":"2017","journal-title":"Int J Infect Dis"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.2147\/IDR.S359596","article-title":"Clinical features of pulmonary Nocardiosis in patients with different underlying diseases: a case series study","volume":"15","author":"Zhong","year":"2022","journal-title":"Infect Drug Resist."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1424564\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T04:26:29Z","timestamp":1721190389000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1424564\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":27,"alternative-id":["10.3389\/fmed.2024.1424564"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1424564","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,17]]},"article-number":"1424564"}}