Pulmonary Nocardiosis—A Mimicker of Tuberculosis in Human Immunodeficiency Virus Patients: Two Case Reports

Background: <i>Nocardia</i> is a gram-positive weakly acid-fast bacterium causing atypical pneumonia in an immunocompromised setting. A mimicker of pulmonary tuberculosis, presenting as cavitating lesions of the lung. It presents with suppurative disease localized to skin and subcutaneou...

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Bibliographic Details
Main Authors: Sumit Arora, Abhinav Kumar, Kuldeep K Ashta, Atul Gogia, Atul Kakar
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-02-01
Series:Journal of Medical Academics
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Online Access:https://www.jmaacms.com/doi/JOMA/pdf/10.5005/jp-journals-11003-0112
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Summary:Background: <i>Nocardia</i> is a gram-positive weakly acid-fast bacterium causing atypical pneumonia in an immunocompromised setting. A mimicker of pulmonary tuberculosis, presenting as cavitating lesions of the lung. It presents with suppurative disease localized to skin and subcutaneous tissue in immunocompetent individuals. It is a rare opportunistic infection in HIV patients with CD4 < 50, on prolonged steroids, at extreme ages, and haematological malignancies presenting with severe disseminated disease. Diagnosis of <i>Nocardia</i> requires the isolation of the organism from invaded tissue and can be stained on the Gram and modified acid-fast stains. Case Description: We report two cases of severe pulmonary nocardiosis diagnosed to have HIV infection on presentation with CD4 counts <50 cell/cmm<sup>3</sup>. Conslusion: We conclude that for patients presenting with subacute cavitating or interstitial pneumonia with immunocompromised status and HIV patients with low CD4 counts, a diagnosis of nocardiosis should be suspected along with tuberculosis and fungal infections.
ISSN:2581-8279