Infectious Diarrhea Caused by Nocardia farcinica in a 19-Month-Old Child

Abstract

Background

Nocardia farcinica, a pathogen known for its strong pathogenicity, is frequently implicated in skin, central nervous system, and lung infections among immunosuppressed hosts, while intestinal nocardiosis is rare. We report the case of infectious diarrhea caused by N. farcinica in a child.

Case Presentation

A 19-month-old female child was admitted to the hospital with fever and diarrhea after the consumption of oranges. The etiological agent responsible for the diarrhea was identified through the examination of fecal smears using weak acid-fast staining and conducting fecal cultures. Whole-genome sequencing was employed to analyze the causative gene. Subsequent to a 5-day treatment regimen with amoxicillin-clavulanate at a dosage of 30 mg/kg every 12 hours, the child’s condition improved significantly, leading to an uncomplicated discharge.

Conclusion

This case illustrates the presence of intestine virulence factors in N. farcinica capable of causing diarrhea. The utilization of weak acid-fast staining in the examination of fecal smears is crucial for the accurate diagnosis of infectious diarrhea caused by Nocardia spp.

Keywords:

• Nocardia farcinica
• diarrhea
• virulence factors

Ethical Approval Statement and Informed Consent

This study was approved by the Ethics Committee of the Second Hospital of Hebei Medical University, with approval number 2022-C022. Written informed consent for publication of case details was obtained from the patient’s parent.

Acknowledgments

We thank the Zhangjiakou First Hospital for their effort in medical records management. We thank International Science Editing for editing this manuscript.

Disclosure

The authors declare no potential conflicts of interest.

Additional information

Funding

This study was supported by Natural Science Foundation of Hebei Province (H2022206277).