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VOLUME 5 , ISSUE 1-2 ( January-December, 2022 ) > List of Articles


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

Sumit Arora, Abhinav Kumar, Kuldeep K Ashta, Atul Gogia, Atul Kakar

Keywords : Human immunodeficiency virus and acquired immunodeficiency syndrome, Nocardiosis, Pneumonia

Citation Information : Arora S, Kumar A, Ashta KK, Gogia A, Kakar A. Pulmonary Nocardiosis—A Mimicker of Tuberculosis in Human Immunodeficiency Virus Patients: Two Case Reports. Journal of Medical Academics 2022; 5 (1-2):20-22.

DOI: 10.5005/jp-journals-11003-0112

License: CC BY-NC 4.0

Published Online: 22-02-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Background: Nocardia 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 Nocardia 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/cmm3. 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.

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  1. Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev 1994;7(2):213–264. DOI: 10.1128/CMR.7.2.213
  2. Ambrosioni J, Lew D, Garbino J. Nocardiosis: updated clinical review and experience at a tertiary center. Infection 2010;38(2):89–97. DOI: 10.1007/s15010-009-9193-9
  3. Sorrell TC. Nocardia species. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 2009;2:3205–3206.
  4. Wilson JW. Nocardiosis: updates and clinical overview. Mayo Clin Proc 2012;87(4):403–407. DOI: 10.1016/j.mayocp.2011.11.016
  5. Pintado V, Gómez-Mampaso E, Cobo J, et al. Nocardial infection in patients infected with the human immunodeficiency virus. Clin Microbiol Infect 2003;9(7):716–720. DOI: 10.1046/j.1469-0691.2003.00588.x
  6. Kanne JP, Yandow DR, Mohammed TL, et al. CT findings of pulmonary nocardiosis. AJR Am J Roentgenol 2011;197(2):W266–W272. DOI: 10.2214/AJR.10.6208
  7. Buckley JA, Padhani AR, Kuhlman JE. CT features of pulmonary nocardiosis. J Comput Assist Tomogr 1995;19(5):726–732. DOI: 10.1097/00004728-199509000-00007
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