Journal of Acute Care

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VOLUME 1 , ISSUE 3 ( September-December, 2022 ) > List of Articles

TUTORIAL

A Case Report of Necrotic Lung Abscess due to Nocardia Otitidiscaviarum

Owais Tisekar, AK Ajith Kumar, Justin A Gopaldas, Rajeev C Mathews, Ranjeeta Adhikary

Keywords : Immunocompetent, Lung abscess, Nocardia, Otitidiscaviarum

Citation Information : Tisekar O, Ajith Kumar A, Gopaldas JA, Mathews RC, Adhikary R. A Case Report of Necrotic Lung Abscess due to Nocardia Otitidiscaviarum. 2022; 1 (3):163-167.

DOI: 10.5005/jp-journals-10089-0037

License: CC BY-NC 4.0

Published Online: 03-05-2023

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


Abstract

Nocardia is a cause of localized or disseminated infection in humans. Nocardia otitidiscaviarum (N. otitidiscaviarum) is an infrequent cause of nocardiosis, accounting for <5% of the cases. N. otitidiscaviarum primarily affects the lungs, skin, and brain, with the lungs being the most common site. Diagnosis can be a challenge, and it requires a high index of suspicion among clinicians. A 52-year-old gentleman presented to our hospital with a 2-month history of fever, cough, and progressive breathlessness. He was started on a high-flow nasal cannula (HFNC) for respiratory failure. The positron emission tomography (PET) showed a left lower lobe mass lesion with a maximum standardized uptake value (SUV) of 17.4. The histopathological findings of the computed tomography (CT)-guided mass biopsy were consistent with an abscess. The identification of Nocardia species was made by Kinyoun staining after decolorization with 1% of sulfuric acid. According to the drug-sensitivity test, the patient was started on trimethoprim/sulfamethoxazole along with imipenem/cilastatin. There was clinical improvement in 3–4 days and the patient was weaned off the HFNC support. Nocardiosis should be an essential consideration for the differential diagnosis of many bacterial, fungal, and viral infections, even in immunocompetent individuals. Early diagnosis and treatment help to improve survival.


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