A rare case report of pulmonary nocardiosis mimicking as lung malignancy

Palaninathan PA, Elias DM, Nagarajan N, Ramakrishnan P, Kumari SL

Pdf Page Numbers :- 241-244

Prem Ananth Palaninathan¹, Divya Mary Elias¹, Nagarajan N¹, Prathipa Ramakrishnan² and Lithya Kumari S⁵

¹Department of Respiratory Medicine, Velammal Medical College & RI, Madurai, Tamil Nadu 625009, India

²Department of Pathology, ACS Medical College, Chennai, Tamil Nadu 600077, India

³Department of Respiratory Medicine, Sri Ramachandra Medical College & RI, Chennai, Tamil Nadu 600116, India

*Corresponding author: Dr. Prem Ananth Palaninathan, Professor, Department of Respiratory Medicine, Velammal Medical College & RI, Madurai, Tamil Nadu 625009, India. Email: premananth86@yahoo.com

Received 13 March 2023; Revised 15 May 2023; Accepted 23 May 2023; Published 31 May 2023

Citation: Palaninathan PA, Elias DM, Nagarajan N, Ramakrishnan P, Kumari SL. A rare case report of pulmonary nocardiosis mimicking as lung malignancy. J Med Sci Res. 2023; 11(3):241-244. DOI: http://dx.doi.org/10.17727/JMSR.2023/11-44

Copyright: © 2023 Palaninathan PA et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Pulmonary nocardiosis is a rare infectious disorder mainly affecting immunocompromised patients. It may remain cryptic which gradually progresses in its course. Our patient was a 37 years old immunocompetent female who presented with radiological picture of left upper lobe opacification. She was treated with empirical anti tuberculosis treatment outside, no radiological improvement seen. After she reported here, she was evaluated with bronchoscopy with biopsy and bronchial wash culture showed Nocardia species. She was managed with trimethoprim-sulphamethoxazole and amikacin with regular follow up for 6 months. She had radiological resolution and clinical improvement after 4 months of treatment. Hence we made the diagnosis of this rare infection in immunocompetent individual and successfully treated her, which was mistreated as pulmonary tuberculosis elsewhere.

Keywords: pulmonary nocardiosis; immunocompetent; modified acid fast stain; trimethoprim-sulpamethoxazole; Nocardia species