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Rationale: Nocardia species are aerobic saprophytic bacilli. Among Nocardia species, Nocardia otitidiscaviarum (N otitidiscaviarum) is rarely reported in pulmonary infection. Patient concerns: We reported a case of N otitidiscaviarum pneumonia in a cotton farmer. Diagnoses: N otitidiscaviarum pneumonia was identified by mass spectroscopy. Interventions: Combined treatments (amikacin, imipenem and trimethoprim-sulfamethoxazole) were administered after identification of N otitidiscaviarum. Outcomes: The patient eventually died from severe respiratory insufficiency in the hospital. Lessons: Early precise diagnosis and prompt combined therapy are of vital importance in severe Nocardia pulmonary infection.

Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer