Open AccessA Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient
Author(s) -
Jin Young Kim,
Min Kyu Kang,
Ju Ri Kim,
So-hee Jung,
Junhung Park,
Dong Kyu Lee,
Hee Jung Yoon
Publication year - 2016
Publication title -
tuberculosis and respiratory diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.837
H-Index - 24
eISSN - 2005-6184
pISSN - 1738-3536
DOI - 10.4046/trd.2016.79.2.101
Subject(s) - medicine , nocardia , mediastinitis , nocardiosis , pneumonia , trimethoprim , sulfamethoxazole , antibiotics , surgery , dermatology , microbiology and biotechnology , bacteria , biology , genetics
Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.