{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:13:50Z","timestamp":1789578830533,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Chronic granulomatous disease (CGD) is an inherited disorder of the Nicotinamide adenine dinucleotide phosphate reduced oxidase complex characterized by recurrent bacterial and fungal infections. Disseminated infection by combination of opportunistic agents is being increasingly reported in CGD patients. We presented in the retrospective review of medical records, the etiology, presentation, clinical characteristics the infections detected, predisposing condition and outcome of nocardiosis and actinomycosis involved in a group of pediatric patients diagnosed with CGD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      The clinical presentation of CGD-related infections was reviewed retrospectively from the medical records of all 12 patients with CGD. We studied respectively 12 patients between 2001 and 2008, and we analyzed two pediatric patients with CGD who acquired\n                      <jats:italic toggle=\"yes\">Nocardia<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Actinomyces<\/jats:italic>\n                      infections, and their clinical and microbiological characteristics were described. The material for investigations was collected from scrapings, crusts, pus from subcutaneous abscesses or exudation from sinus tracts, surgical debridement, and biopsy specimens. The microbiological diagnosis was determined by biochemical tests, histology, microscopy, and culture of clinical samples.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The medical records of 12 diagnosed CGD patients with suspected nocardiosis or actinomycosis were reviewed. One patient was diagnosed with actinomycosis and one patient with nocardiosis. Patients consisted of seven males and five females with ranging ages of 3 to 18 years. Nocardiosis and actinomycosis isolated in the two patients were confirmed by histology and culture methods. Neutrophil oxidative burst were absent (NBT=0) in both patients. The most common manifestations of CGD due to fungal infections, actinomycosis, and nocardiosis were osteomyelitis (42.8%), pulmonary infections (28.6%), lymphadenopathy (14.3%), and skin involvement (14.3%) during their illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Nocardiosis and actinomycosis in children indicate the need for evaluation for an underlying immunological deficiency. Early diagnosis remains critical for decreased morbidity and occasional mortality. Physicians caring for patients with CGD should maintain a high index of suspicion for nocardiosis and actinomycosis especially if work up for TB and fungal infections are negative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0974-777x.91056","type":"journal-article","created":{"date-parts":[[2011,12,21]],"date-time":"2011-12-21T01:29:49Z","timestamp":1324430989000},"page":"348-352","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Actinomyces and Nocardia Infections in Chronic Granulomatous Disease"],"prefix":"10.4103","volume":"3","author":[{"given":"Shahindokht","family":"Bassiri-Jahromi","sequence":"first","affiliation":[{"name":"Medical Mycology Department, Pasteur Institute of Iran and Education Deceleopment Centre, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Doostkam","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Science, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250523","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1056\/NEJM200012073432307","article-title":"Immunodeficiency Diseases Caused by Defects in Phagocytes","volume":"343","author":"Lekstrom-Himes","year":"2000","journal-title":"N Engl J Med"},{"key":"R2-20250523","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0031-3955(16)33424-1","article-title":"Chronic granulomatous disease","volume":"24","author":"Johnston","year":"1977","journal-title":"Pediatr Clin North Am"},{"key":"R3-20250523","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/00005792-200005000-00003","article-title":"Chronic granulomatous disease.Report on a national registry of 368 patients","volume":"79","author":"Winkelstein","year":"2000","journal-title":"Medicine (Baltimore)"},{"issue":"Suppl 3","key":"R4-20250523","doi-asserted-by":"crossref","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":"R5-20250523","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1086\/341416","article-title":"Nocardia infection in Chronic Granulomatous Disease","volume":"35","author":"Dorman","year":"2002","journal-title":"Clin Infect Dis"},{"issue":"Suppl 11","key":"R6-20250523","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1086\/647945","article-title":"Actinomyces in chronic granulomatous disease: An emerging and unanticipated pathogen","volume":"49","author":"Reichenbach","year":"2009","journal-title":"Clin Infect Dis"},{"key":"R7-20250523","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1128\/am.25.4.665-681.1973","article-title":"Laboratory identification of clinically important aerobic actinomycetes","volume":"25","author":"Berd","year":"1973","journal-title":"Appl Microbiol"},{"key":"R8-20250523","first-page":"728","article-title":"Identification of Nocardiae and streptomycetes of medical importance","volume":"11","author":"Mishra","year":"1980","journal-title":"JClinMicrobiol"},{"issue":"Suppl 1","key":"R9-20250523","first-page":"93","article-title":"Disseminated infection due to Fusarium sp In a patient with chronic granulomatous disease","volume":"12","author":"BassiriJahromi","year":"1998","journal-title":"Med J IslamRepub Iran"},{"key":"R12-20250523","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/BF01103766","article-title":"First reported Nocardia otitidiscaviarum infection in an AIDS patient in Italy","volume":"126","author":"Castelli","year":"1994","journal-title":"Mycopathologia"},{"issue":"Suppl 4","key":"R13-20250523","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1542\/peds.55.4.479","article-title":"Nocardiosis in children: Report of three cases and review of the literature","volume":"55","author":"Idriss","year":"1975","journal-title":"Pediatrics"},{"key":"R14-20250523","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/BF01989975","article-title":"Review of nocardial infections in France 1987 to 1990","volume":"11","author":"Boiron","year":"1992","journal-title":"Eur J ClinMicrobiol Infect Dis"},{"issue":"Suppl 6","key":"R15-20250523","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1093\/clinids\/22.6.891","article-title":"Nocardiosis","volume":"22","author":"Lerner","year":"1996","journal-title":"Clin Infect Dis"},{"key":"R16-20250523","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1086\/368388","article-title":"Reinfection, rather than persistent infection, in patients with chronic granulomatous disease","volume":"187","author":"Guide","year":"2003","journal-title":"J Infect Dis"},{"key":"R17-20250523","first-page":"940","article-title":"Nocardia infections in chronic granulomatous disease [abstract 105]. 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