Diseminated nocardiosis: a case report

Abstract

Nocardiosis is a rare infection caused by bacteria of the genus Nocardia, saprophytic germs of worldwide distribution, the transmission is by inhalation or direct inoculation. Pulmonary and disseminated presentation predominantly affects immunocompromised patients. Since the infection is uncommon, a high index of suspicion should be taken for its diagnosis. The definitive diagnosis is made by molecular techniques. This article describes the case of a young patient, with no remarkable personal history, with a history of skin lesion and acute steroid use, which rapidly develops bilateral pulmonary infiltrates and falls into acute respiratory failure, meriting management in the intensive care unit. Both filamentous structures suggestive of Nocardia were observed in the sputum and skin lesion culture, he received treatment with intravenous meropenem and linezolid with an excellent clinical response. The patient was able to be discharged and the use of oral linezolid was approved to complete treatment at home.