A life-threatening case of disseminated nocardiosis due to Nocardia brasiliensis

Abstract

Nocardiosis is a rare disease caused by infection with Nocardia species, aerobic actinomycetes with a worldwide distribution. A rare life-threatening disseminated Nocardia brasiliensis infection is described in an elderly, immunocompromised patient. Microorganism was recovered from bronchial secretions and dermal lesions, and was identified using molecular assays. Prompt, timely diagnosis and appropriate treatment ensured a favorable outcome.

Keywords: Nocardia; Nocardia brasiliensis; nocardiosis.

Figure 1(a and b)

A cutaneous lesion on patients’ forehead and left arm correspondingly

Figure 2

Anteroposterior chest X-ray demonstrating opacity in both lung fields

Figure 3

Computed tomography scan of the chest demonstrating densities and diffuse nodular lesions, some presenting cavitations

Figure 4

Photomicrograph of sputum smear showing acid fast, beaded filamentous bacteria with typical right angle branching (×2400)

Figure 5

White, dry chalk colonies of Nocardia brasiliensis after 3 days of incubation at room temperature on Columbia blood agar plate

Figure 6

Photomicrograph of bacteria grown in MGIT960 tubes showing acid fast, beaded filamentous bacteria (×2400).