Pulmonary nocardiosis in a HIV infected patient

Kulkarni, SD; Baradkar, VP; Kumar, S

doi:10.4103/0253-7184.48733

Cited by 1 publication

(1 citation statement)

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“…Limited studies have been reported from India regarding pulmonary nocardiosis, and most of them are case reports [1,3,8,[15][16][17][18][19]. From the western part of India, these only a few cases have been reported [20][21].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Radiological Findings, and Treatment Outcomes in Patients with Pulmonary Nocardiosis: A Retrospective Analysis

Yadav¹,

Kumar²,

Meena³

et al. 2021

Cureus

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IntroductionLack of specific clinical features makes the diagnosis of pulmonary nocardiosis difficult. A high index of suspicion is required for diagnosis especially in cohorts with pre-existing risk factors. This study aimed to study the clinical and radiological characteristics and outcomes in patients with pulmonary nocardiosis. MethodsThis was a retrospective observational study. Data of confirmed cases with pulmonary nocardiosis were collected from a digital patient management system. ResultsA total of eight cases of pulmonary nocardiosis were included. The mean age of patients was 50 ± 14.3 years with a female preponderance (62.5%). The most common co-morbidity was chronic lung disease (37.5%). The common clinical feature of pulmonary nocardiosis was cough with expectoration (50%) and the mean duration of symptoms was 18 days. The common radiological (CT thorax) findings were consolidation, bronchiectasis, mediastinal lymphadenopathy, and nodularity (50% each). One patient had an extension of pulmonary disease in the chest wall. Microbiological detection of Nocardia spp. was done in sputum samples (50%) and in bronchoalveolar lavage (BAL) samples (50%). Culture was positive in two BAL samples. Intravenous empirical antibiotics in combination with oral trimethoprim-sulfamethoxazole double standard (15 mg/kg trimethoprim) were started at the time of diagnosis. Ceftriaxone and amikacin were commonly used antimicrobials. ConclusionNocardia spp. commonly causes disease in patients with pre-existing chronic disease. A high index of suspicion is required in patients with subacute to chronic respiratory symptoms, raised inflammatory markers, and the absence of common respiratory pathogens in evaluation.

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