Nocardia otitidiscaviarum causing pulmonary nocardiosis: a case report and its review of the literature
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Background. Infections caused by Nocardia spp. can occur in immunocompromised as well as immunocompetent individuals. Although nocardiosis is rare, it is being increasingly recognized owing to the rise in occurrence rate over the years. The documentation of pleural involvement in nocardiosis is rare in India.
Case. We report a case of pulmonary nocardiosis in an immunocompromised individual caused by Nocardia otitidiscaviarum .
Discussion. Pulmonary nocardiosis caused by Nocardia otitidiscaviarum may go unnoticed without clinical suspicion. Correct and timely identification is the key to proper patient management.
Conclusion. Coordination between clinicians and microbiologists is necessary for early diagnosis and appropriate management of nocardiosis.
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Thank you very much for submitting your revised manuscript to Access Microbiology and implement the suggestions from reviewers. The manuscript is now accepted for publication. Congratulations to all authors!
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Thank you very much for submitting your revised manuscript to Access Microbiology. We really appreciate your efforts in implementing the reviewer suggestions, and the manuscript has undoubtedly improved thanks to that. There are still some reviewer suggested amendments needed, which are merely editorial and format-related, before progressing to acceptance.
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Comments to Author
All my comments were successively addressed. It is good that additional information was listed from the cited references in Table 1 and that they were included in the Discussion. I have additional editorial comments according to Table 1. The title of Table 1 instead of "Review of literature" should be more precise. My comment concerning the Autor column is that only names should be listed I want to be more precise; i.e. please use the same convention in this column in the whole table. I propose instead "Katherine Fu" use "Fu et al". In the risk factor column, please use a small letter where possible. l. 195 "Clarithromycin" please use small letters l.196 and l. 198 please correct "N. cyriacigeorgica" Fig 2A caption please change "Gram-positive"
Please rate the quality of the presentation …
Comments to Author
All my comments were successively addressed. It is good that additional information was listed from the cited references in Table 1 and that they were included in the Discussion. I have additional editorial comments according to Table 1. The title of Table 1 instead of "Review of literature" should be more precise. My comment concerning the Autor column is that only names should be listed I want to be more precise; i.e. please use the same convention in this column in the whole table. I propose instead "Katherine Fu" use "Fu et al". In the risk factor column, please use a small letter where possible. l. 195 "Clarithromycin" please use small letters l.196 and l. 198 please correct "N. cyriacigeorgica" Fig 2A caption please change "Gram-positive"
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Thank you very much submitting your manuscript to Access Microbiology. It has now been reviewed by two experts in the field, who have made several suggestions for improvement of your manuscript. Please address them thoroughly, specially those concerning a reorganisation of the figures and the need for a better elaboration of the Discussion section. As the title indicates that the manuscript will contain a literature review, this part of the work needs to be substantially better elaborated to be comprehensive and informative to the reader.
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Comments to Author
The manuscript concerns the fatal case of Nocardia otidiscaviarum pulmonary infection in an immunocompromised patient. The case report is presented well but the paper needs some improvements. Major remarks 1. Introduction, l.79-80. Please correct this sentence cause more than 100 different species in the Nocardia genus were identified and the reference cited was from 2013. 2. Case presentation, lines 133-135. The authors should write more details concerning the MALDI-TOF identification. (Score value, producer, database) 3. The comment about antibiotic sensitivity of different Nocardia spp should be included in the discussion section. 4. Besides preparing Table 1 in the discussion section it should be briefly analysed not in one sentence only. The table should have the title " Review of N. …
Comments to Author
The manuscript concerns the fatal case of Nocardia otidiscaviarum pulmonary infection in an immunocompromised patient. The case report is presented well but the paper needs some improvements. Major remarks 1. Introduction, l.79-80. Please correct this sentence cause more than 100 different species in the Nocardia genus were identified and the reference cited was from 2013. 2. Case presentation, lines 133-135. The authors should write more details concerning the MALDI-TOF identification. (Score value, producer, database) 3. The comment about antibiotic sensitivity of different Nocardia spp should be included in the discussion section. 4. Besides preparing Table 1 in the discussion section it should be briefly analysed not in one sentence only. The table should have the title " Review of N. otitidiscaviarum cases", and in the "Author" column only names should be listed. Minor remarks Abstract, lines 59-60 "especially in the northwestern region" is not important in the abstract, especially since it is not mentioned in the manuscript text. l. 60-61 please remove this sentence l. 72 , please add "Ziehl-Neelsen staining" in the keywords l. 84 N. veterana l. 122 please explain BD abbreviation l. 131-133 please remove this sentence due to the repetition l. 146 "immunocompetent as well as immunocompromised" l. 148-l. 156 please change the references to the numbers l. 157 "Shan Li et al" is not listed in the references list l. 182 Nocardia with italic Figures I propose to change the figure numeration in the manuscript: Fig. 1 as it is, Fig. 2 A and B (Figure 2 and 3), and Figure 3 A,B,C from Figure 4,5,6).
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Comments to Author
1. Description of the case(s): Was CT Chest done? As patients was hospitalized for more than 2 weeks, need more details about his clinical course including important laboratories like secondary infection, medical management, interventions, life saving supportive therapies etc. 2. Presentation of results: Ok 3. How the style and organization of the paper communicates and represents key findings: Satisfactory 4. Literature analysis or discussion: In discussion section, need to mention about why this case is different/ rare / uncommon. What were the risk factors in this presented care. Better, if literature review (Table 1) focus on case reports from Indian subcontinent having pulmonary involvement (lung and pleura). Also, Table should have separate columns for Presence of risk factor, Time gap …
Comments to Author
1. Description of the case(s): Was CT Chest done? As patients was hospitalized for more than 2 weeks, need more details about his clinical course including important laboratories like secondary infection, medical management, interventions, life saving supportive therapies etc. 2. Presentation of results: Ok 3. How the style and organization of the paper communicates and represents key findings: Satisfactory 4. Literature analysis or discussion: In discussion section, need to mention about why this case is different/ rare / uncommon. What were the risk factors in this presented care. Better, if literature review (Table 1) focus on case reports from Indian subcontinent having pulmonary involvement (lung and pleura). Also, Table should have separate columns for Presence of risk factor, Time gap between onset of sign/symptoms & definitive therapy initiation, Patient outcome. 5. Any other relevant comments
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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In this manuscript, the authors present a case report of pulmonary nocardiosis, describing the course of the disease and treatment and the microbiological traits of the pathogen Nocardia otitidiscaviarum. As such, the report is a valuable contribution to the medical literature. However, after different consultations with the Editorial Office, we agree that the section about the literature review should be improved before progressing the manuscript to peer-review. In particular, we believe that the paper would greatly benefit from a deeper discussion of the differences and commonalities between previous reports and the one your present here, either where you state that you have done a literature review (line 179) or in the discussion. This would be much more appreciated by the potential readers.
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