Intra Peritoneal Abscess As The Clinical Outcomes Of Nocardia Asteroides | 51499
Journal of Gastrointestinal & Digestive System
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Background: Nocardiosis is an uncommon bacterial infection that is caused by aerobic actinomycetes of the genus Nocardia.
This pathogen has emerged as an important cause of mortality and morbidity among both immunocompetent and (more
commonly) immunocompromised hosts. The prevalence of Nocardiosis is unknown in Pakistan. In this study, we performed a
7-year retrospective review of all cases of Nocardiosis identified at the Abbasi Shaheed Hospital in Karachi. Clinical presentation,
risk factors, site of disease involvement, radiological features, and outcomes of 55 patients with peritoneal abscess complication
were presented. The present study identifies the risk factors for Nocardiosis, clinical symptoms and radiographic features and
the factors that affect its prognosis.
Materials & Methods: A retrospective review of all cases of Nocardiosis over the last seven years.
Results: Fifty five cases of Nocardiosis with intra peritoneal abscess were identified for surgery. The disease was more
common in males. Fever, cough and dyspnea were the most common presentation. Most of the patients had chronic steroid
administration and an underlying malignancy. The most frequent abnormality in the chest X-ray was pleural effusion followed
by consolidation. Cure was possible in thirty six cases, while nineteen patients died. Co-trimaxazole was most commonly used
for the treatment. Duration of therapy ranged from 12 days to 95 days. Chest tube placement was indicated in 13 patients. Most
common complication observed was pulmonary infection but least common were intra-abdominal peritoneal abscess.
Conclusion: Nocardiosis is difficult to diagnose as diagnosis is frequently delayed and a high level of suspicion is, thus, required
in patients with underlying diseases or chronic corticosteroid therapy. Also, there is frequent dissemination and high mortality
associated with Nocardia. Prevalence is not known in Pakistan. A database is urgently needed to better evaluate the prevalence
of the illness among the Pakistani population.
Muhammad Khurram Zia is serving at an esteemed academic position in Atia General Hospital, Pakistan. He has worked for more than 10 years in the related field and gained a plethora of knowledge in related field. His international experience includes various programs, contributions to reputed journals and participation in different international conferences in diverse fields of study.