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PEDIATRICS Vol. 104 No. 4 October 1999, pp. 961-964

EXPERIENCE AND REASON:
Nocardia farcinica Pneumonia in Chronic Granulomatous Disease

Received Jan 11, 1999; accepted Apr 5, 1999.

Avinash K. Shetty, Ann M. Arvin, and Kathleen M. Gutierrez

Department of Pediatrics Stanford University School of Medicine and Lucile Salter Packard Children's Hospital at Stanford Stanford, CA 94040

Infection with Nocardia poses a diagnostic challenge in patients with chronic granulomatous disease (CGD) because the signs and symptoms are often nonspecific, delay in diagnosis is common, and invasive procedures are frequently required to obtain appropriate tissue specimens. We present the first reported case of N farcinica pneumonia in an adolescent with X-linked CGD. Differentiation of N farcinica from other members of N asteroides complex is important because of its propensity for causing disseminated infection and antimicrobial resistance. Physicians caring for patients with CGD should maintain a high index of suspicion for nocardiosis, especially in those receiving chronic steroid therapy. Early diagnosis remains critical for decreased morbidity and occasional mortality.

 Key words:  Nocardia farcinica, chronic granulomatous disease, pneumonia.




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