Nocardia caishijiensis infection: a case report and review of the literature.

BACKGROUND: Nocardia caishijiensis is a rare soil actinomycete first described in Anhui province, China, in 2003. There has been only one reported instance of human infection caused by this species in the current literature. CASE PRESENTATION: We present a case of pulmonary nocardiosis caused by Nocardia caishijiensis in a fifty-two-year-old man with human immunodeficiency virus infection and concomitant use of high-dose dexamethasone for cervical myelopathy, treated successfully with amikacin and thrimetroprim-sulfametoxazole, antibiotic resistance pattern was obtained, although interpretation may be limited. CONCLUSION: To our knowledge, this is the first reported case of Nocardia caishijiensis infection in humans in North America and the second one in the literature, this pathogen should be recognized as a potentially rising etiology of nocardiosis, especially in solid organ transplant recipients. This has a rising importance as the survival for solid organ recipients continue to rise with advance in transplant medicine leading to increased life expectancy in this particularly susceptible group.

Unusual presentation of endocarditis with nutritional variant Streptococci.

Patients presenting with endocarditis often will give clues to the diagnosis within the history and the physical exam. A history of valvular heart disease and obvious signs of bacteriemia are classical stigmata of infective endocarditis. However, we should keep in mind that endocarditis can present with unusual signs and symptoms that can mislead to the wrong diagnosis and if unrecognized it can lead to severe complications.