Nocardia Infections Successfully Treated with a Tedizolid-Based Regimen in Two Heart Transplant Recipients

Nocardia is an opportunistic pathogen associated with life-threatening infections, particularly in solid organ transplant recipients. In this population, combination therapy with two or more antibiotics and prolonged treatment duration are generally recommended to minimize the risk of relapse, although tolerability issues may adversely affect clinical outcomes. Herein, we present two cases of Nocardia infection in heart transplant recipients treated with short-term treatment (<180 days), including tedizolid. This treatment was effective in treating pulmonary nocardiosis in a heart transplant recipient, while remodulation of the immunosuppressive regimen to restore immune function with a longer course of antimicrobial therapy (7 months) contributed to successful treatment in the second case. These two cases are anecdotal, and there are currently only a few case series reported in the literature to support recommending a short course of treatment for Nocardia infection in SOT recipients. Nevertheless, the occurrence of adverse effects or tolerability issues during prolonged treatment may make a shorter treatment approach an interesting option to explore.