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First Case of Actinomycetoma in France Due to a Novel Nocardia Species, Nocardia boironii sp. nov.

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ABSTRACT

Bacterial mycetoma is an endemic infection in areas with tropical and subtropical climates. Thus, its presence in temperate climate areas remains rare. We report here the first case of autochthonous actinomycetoma in continental France originating from a Nocardia species other than N. brasiliensis, namely, Nocardia boironii. Considering the history of the patient, the infection source of strain OFN 14.177T may be from frequent contact with the soil over many years because of his gardening activities. The discovery of a French autochthonous Nocardia species responsible for actinomycetoma reveals the importance of considering the possibility of having autochthonous infections of this type in nontropical countries, not only imported cases from tropical countries. However, further studies are needed to elucidate the real incidence of this new species.

No MeSH data available.


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(a) Mycetoma aspect of the patient in the right forearm. Two purplish nodular lesions of 1 to 2 cm over a small indolent subcutaneous tumefaction of 2 by 3 cm and an indurated scar on the right elbow. (b) Histologic findings revealed a suppurative granuloma surrounding grains stained with periodic acid-Schiff (PAS) stain; granulomas were composed of neutrophils surrounded by a mixed inflammatory infiltrate comprising lymphocytes, macrophages, and numerous multinucleated giant cells. (c) At a higher magnification, histologic findings showed short hyphae that could sometimes be observed within the giant cells (PAS stain). (d) The morphology of colonies of the isolate OFN 14.177T on Bennett agar after 10 days at 28°C. Regarding the OFN 14.177T strain, we obtained yellow/orange and dome-shaped colonies 1 to 3 mm in diameter, exhibiting a rough and dry aspect and a slight aerial mycelium at the colony surface after 7 days of culture on Bennett agar at 28°C. (e) Phylogenetic trees based on the 16S rRNA, hsp65, secA1, and sod gene sequences of our OFN 14.177T strain and the closest Nocardia type strains. These trees are based on the analysis of a 1,325-nt fragment of the 16S rRNA gene, a 401-nt fragment of the hsp65 gene, a 551-nt fragment of the secA1 gene, and a 444-nt fragment of the sod gene. Evolutionary trees were obtained from the distance matrix by the neighbor-joining method (16). The bootstrap values were calculated by random resampling of the sequences (n = 1,000) to obtain the most representative phylogenetic tree. The bars show 0.005 or 0.01 nucleotide substitutions per position.
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fig1: (a) Mycetoma aspect of the patient in the right forearm. Two purplish nodular lesions of 1 to 2 cm over a small indolent subcutaneous tumefaction of 2 by 3 cm and an indurated scar on the right elbow. (b) Histologic findings revealed a suppurative granuloma surrounding grains stained with periodic acid-Schiff (PAS) stain; granulomas were composed of neutrophils surrounded by a mixed inflammatory infiltrate comprising lymphocytes, macrophages, and numerous multinucleated giant cells. (c) At a higher magnification, histologic findings showed short hyphae that could sometimes be observed within the giant cells (PAS stain). (d) The morphology of colonies of the isolate OFN 14.177T on Bennett agar after 10 days at 28°C. Regarding the OFN 14.177T strain, we obtained yellow/orange and dome-shaped colonies 1 to 3 mm in diameter, exhibiting a rough and dry aspect and a slight aerial mycelium at the colony surface after 7 days of culture on Bennett agar at 28°C. (e) Phylogenetic trees based on the 16S rRNA, hsp65, secA1, and sod gene sequences of our OFN 14.177T strain and the closest Nocardia type strains. These trees are based on the analysis of a 1,325-nt fragment of the 16S rRNA gene, a 401-nt fragment of the hsp65 gene, a 551-nt fragment of the secA1 gene, and a 444-nt fragment of the sod gene. Evolutionary trees were obtained from the distance matrix by the neighbor-joining method (16). The bootstrap values were calculated by random resampling of the sequences (n = 1,000) to obtain the most representative phylogenetic tree. The bars show 0.005 or 0.01 nucleotide substitutions per position.

Mentions: Upon physical examination, his temperature was 38.5°C, and he had a pulse rate of 95/min, blood pressure of 120/80 mm Hg, and oxygen saturation of 85% while breathing ambient air. There were crepitations at both pulmonary bases, edema of the legs, and hepatojugular reflux. Details about the skin examination are presented in Fig. 1a. There was no lymphadenopathy. The remainder of the examination was normal.


First Case of Actinomycetoma in France Due to a Novel Nocardia Species, Nocardia boironii sp. nov.
(a) Mycetoma aspect of the patient in the right forearm. Two purplish nodular lesions of 1 to 2 cm over a small indolent subcutaneous tumefaction of 2 by 3 cm and an indurated scar on the right elbow. (b) Histologic findings revealed a suppurative granuloma surrounding grains stained with periodic acid-Schiff (PAS) stain; granulomas were composed of neutrophils surrounded by a mixed inflammatory infiltrate comprising lymphocytes, macrophages, and numerous multinucleated giant cells. (c) At a higher magnification, histologic findings showed short hyphae that could sometimes be observed within the giant cells (PAS stain). (d) The morphology of colonies of the isolate OFN 14.177T on Bennett agar after 10 days at 28°C. Regarding the OFN 14.177T strain, we obtained yellow/orange and dome-shaped colonies 1 to 3 mm in diameter, exhibiting a rough and dry aspect and a slight aerial mycelium at the colony surface after 7 days of culture on Bennett agar at 28°C. (e) Phylogenetic trees based on the 16S rRNA, hsp65, secA1, and sod gene sequences of our OFN 14.177T strain and the closest Nocardia type strains. These trees are based on the analysis of a 1,325-nt fragment of the 16S rRNA gene, a 401-nt fragment of the hsp65 gene, a 551-nt fragment of the secA1 gene, and a 444-nt fragment of the sod gene. Evolutionary trees were obtained from the distance matrix by the neighbor-joining method (16). The bootstrap values were calculated by random resampling of the sequences (n = 1,000) to obtain the most representative phylogenetic tree. The bars show 0.005 or 0.01 nucleotide substitutions per position.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5120171&req=5

fig1: (a) Mycetoma aspect of the patient in the right forearm. Two purplish nodular lesions of 1 to 2 cm over a small indolent subcutaneous tumefaction of 2 by 3 cm and an indurated scar on the right elbow. (b) Histologic findings revealed a suppurative granuloma surrounding grains stained with periodic acid-Schiff (PAS) stain; granulomas were composed of neutrophils surrounded by a mixed inflammatory infiltrate comprising lymphocytes, macrophages, and numerous multinucleated giant cells. (c) At a higher magnification, histologic findings showed short hyphae that could sometimes be observed within the giant cells (PAS stain). (d) The morphology of colonies of the isolate OFN 14.177T on Bennett agar after 10 days at 28°C. Regarding the OFN 14.177T strain, we obtained yellow/orange and dome-shaped colonies 1 to 3 mm in diameter, exhibiting a rough and dry aspect and a slight aerial mycelium at the colony surface after 7 days of culture on Bennett agar at 28°C. (e) Phylogenetic trees based on the 16S rRNA, hsp65, secA1, and sod gene sequences of our OFN 14.177T strain and the closest Nocardia type strains. These trees are based on the analysis of a 1,325-nt fragment of the 16S rRNA gene, a 401-nt fragment of the hsp65 gene, a 551-nt fragment of the secA1 gene, and a 444-nt fragment of the sod gene. Evolutionary trees were obtained from the distance matrix by the neighbor-joining method (16). The bootstrap values were calculated by random resampling of the sequences (n = 1,000) to obtain the most representative phylogenetic tree. The bars show 0.005 or 0.01 nucleotide substitutions per position.
Mentions: Upon physical examination, his temperature was 38.5°C, and he had a pulse rate of 95/min, blood pressure of 120/80 mm Hg, and oxygen saturation of 85% while breathing ambient air. There were crepitations at both pulmonary bases, edema of the legs, and hepatojugular reflux. Details about the skin examination are presented in Fig. 1a. There was no lymphadenopathy. The remainder of the examination was normal.

View Article: PubMed Central - PubMed

ABSTRACT

Bacterial mycetoma is an endemic infection in areas with tropical and subtropical climates. Thus, its presence in temperate climate areas remains rare. We report here the first case of autochthonous actinomycetoma in continental France originating from a Nocardia species other than N. brasiliensis, namely, Nocardia boironii. Considering the history of the patient, the infection source of strain OFN 14.177T may be from frequent contact with the soil over many years because of his gardening activities. The discovery of a French autochthonous Nocardia species responsible for actinomycetoma reveals the importance of considering the possibility of having autochthonous infections of this type in nontropical countries, not only imported cases from tropical countries. However, further studies are needed to elucidate the real incidence of this new species.

No MeSH data available.


Related in: MedlinePlus