Mixed Infection of Cytomegalovirus and Pulmonary Nocardiosis Caused by Nocardia elegans Diagnosed Using Nanopore Sequencing Technology

Intern Med. 2022 May 15;61(10):1613-1617. doi: 10.2169/internalmedicine.7639-21. Epub 2021 Oct 26.

Abstract

A 69-year-old woman who had undergone renal transplantation and was receiving sulfamethoxazole/trimethoprim (ST) developed pulmonary nocardiosis. To our knowledge, this is the first report of the identification of Nocardia elegans using nanopore sequencing, supported by 16S rDNA capillary sequencing findings. Chest computed tomography performed after ST initiation revealed significant improvement of the pulmonary shadows compared to previous findings. We herein report the value of nanopore sequencing for rapid identification of rare pathogens, such as Nocardia elegans. Furthermore, our findings suggest that Nocardia may infect even patients receiving ST, which is currently the most effective prophylactic drug.

Keywords: immunocompromised; nanopore sequencing; nocardiosis; organ transplantation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coinfection* / complications
  • Cytomegalovirus
  • Female
  • Humans
  • Nanopore Sequencing*
  • Nocardia Infections* / diagnosis
  • Nocardia* / genetics
  • Technology
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Trimethoprim, Sulfamethoxazole Drug Combination

Supplementary concepts

  • Nocardia elegans