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Table 1 Cases of Nocardia spp. adrenal abscesses reported in literature (NR: not reported)

From: Bacteremia and adrenal gland abscess due to Nocardia cyriacigeorgica: a case report and review

References

Years

Patients characteristics

Symptoms

Disseminated Nocardiosis

Adrenal abscess side/Nocardia species

Treatment

Outcome

Kim et al. [25]

1991

Male, 38 years, AIDS

Left upper quadrant abdominal pain, fever, chills

Paraaortic and mesenteric lymphadenopathy

Left/N. asteroides

Cefoxitin

Surgical drainage of the mass

Died

Arabi et al. [23]

1996

Male, 39 years, AIDS

Epigastric pain, fever, vomiting

Brain, bacteremia

Bilateral/N. asteroides

Cefotetan, gentamicin, doxycycline then TMP-SMX, imipenem, amikacin, and ciprofloxacin

Survived

Midiri et al. [26]

1998

Female, 49 years, rheumatoid arthritis treated by corticosteroid therapy

Fever and left flank plain

Lung, spleen

Left/N. asteroides

TMP-SMX

Left adrenalectomy

Survived

Moiton et al. [11]

2002

Male, 69 years, active cancer, steroids

Pneumoniae, aphasia, motor deficit

Lung, brain, bacteremia

NR/N. farcinica

NR

Died

Chong et al. [27]

2004

Male, 34 years, AIDS

Fever, left loin pain, hematuria

No other location

Left/N. asteroides

Ceftriaxone, TMP-SMX

Laparoscopic drainage

Survived

Elsayed et al. [19]

2005

Female, 69 years, type 2 diabetes mellitus, chronic lymphocytic leukemia, hypogammaglobulinemia

Malaise, right-sided flank and pleuritic chest discomfort, left leg weakness, ataxic gait

Lung, brain, bacteremia

Right/N. cyriacigeorgica

Meropenem, TMP-SMX

Survived (mild to moderate speech impairment, generalized weakness)

Haussaire et al. [10]

2008

Male, 35 years, kidney transplant, immunosuppressor treatment (calcineurin inhibitor, antimetabolite, steroids)

NR

Lung, kidney, pancreas, adrenal glands, bacteremia

NR/N. farcinica

TMP-SMX, carbapenem, amikacin

Survived

(hypoacusis)

Tachezy et al. [28]

2009

Female, 71 years, former alcohol addiction, malnutrition

Fever, non-productive cough, adynamia

Lung, inferior vena cava, right hepatic and renal capsule, diaphragm, brain

Right/N. farcinica

Imipenem, amikacin, TMP-SMX then TMP-SMX alone

Right adrenalectomy with resection of IVC diaphragm, retroperitoneum and Gerota’s fascia

Survived

Al-Tawfiq and Al-Khatti [29]

2010

Female, 66 years, psoriasis treated by TNF-alpha therapy, type 2 diabetes

Fever, chills, profuse sweating, left upper quadrant abdominal pain

Left renal vein, spleen, retroperitoneal and mesenteric lymphadenopathies

Bilateral/N. farcinica

Vancomycin, meropenem then TMP-SMX, linezolid

Aspiration and biopsy of the left adrenal lesion

Died

de Montmollin et al. [24]

2012

Female, 59 years, chronic parenteral nutrition, malnutrition, hemodialysis

Fever, right lumbar region pain

Bacteremia

Right/N. farcinica

Amikacin, cefuroxime then TMP-SMX

Echography-guided aspiration and drainage

Died

Jackson et al. [6]

2017

Male, 69 years

Fever, night sweats, left upper quadrant abdominal pain

Lung, central nervous system, bone marrow, left renal vein, bacteremia, urine

Left/N. farcinica

Meropenem, TMP-SMX

Survived

Jackson and Shorman [20]

2018

Male, 39 years, splenectomy, intravenous drug user

Fever, generalized weakness, abdominal pain, orthostatic symptoms

Heart, bacteremia

Bilateral/N. farcinica

Meropenem, TMP-SMX

Bilateral percutaneous drains in the adrenal glands

Survived (at 4 weeks of treatment, then lost to follow-up)

Langmaid et al. [21]

2020

Male, 35 years, immunocompetent

Fever, dry cough and left-sided abdominal pain

Lung

Left/N. cyriacigeorgica

Meropenem, TMP-SMX then ceftriaxone and TMP-SMX

Left adrenalectomy

Survived

Pender et al. [22]

2022

Male, 57 years, poorly controlled type 2 diabetes mellitus

Left upper quadrant abdominal pain, subjective fevers, diaphoresis, tachycardia, anorexia, nausea, weight loss

Lung

Left/N. beijingensis

TMP-SMX, linezolid

Left adrenalectomy

Survived

This case

2017

Male, 77 years, no predisposing factors

Deterioration of general status, depressive syndrome, respiratory distress

Lung, brain, bacteremia

Left/N. cyriacigeorgica

Cefotaxime, TMP-SMX then cefotaxime, clarithromycin then doxycycline and clarithromycin

Survived