Post COVID nocardiosis-an opportunistic enemy

Authors

  • Kulwant Sesodia Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, India
  • Pooja Khosla Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, India
  • Vinus Taneja Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, India
  • Rishikesh Dessai Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232815

Keywords:

Nocardia, Nocardia beijingensis, COVID-19

Abstract

Nocardia is an opportunistic infection seen mostly in immunocompromised individuals. It has become an important pathogen especially in these post covid times in which multiple individuals had to go through high dose corticosteroid therapy as part of their severe COVID-19 treatment. We present a 62 years old male with diabetes mellitus and hypertension who had previously been hospitalized for a month for COVID-19 and received high dose corticosteroids for the same. He presented again one month later with symptoms of fever and breathlessness and was worked up extensively for infections in which all his investigations came negative. For suspicion of opportunistic pathogen his HRCT thorax was done which showed consolidation and cavitation in lung along with other infective changes. In view of HRCT thorax findings bronchoscopy was done and bronchoalveolar lavage was sent for examination which grew Nocardia beijingensis on culture. Cotrimoxazole was started for the patient and 3 days after the initiation of therapy he became afebrile and was weaned off of oxygen support gradually over next one month.

Metrics

Metrics Loading ...

References

Lerner PI. Nocardiosis. Clin Infect Dis. 1996;22(6):891-903.

Wilson JW. Nocardiosis: updates and clinical overview. Mayo Clin Proc. 2012;87:403-7.

Van Paassen J, Vos JS, Hoekstra EM, Neumann KMI, Boot PC, Arbous SM. Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes. Crit Care. 2020;24:696.

Traxler RM, Bell ME, Lasker B, Headd B, Shieh WJ, McQuiston JR. Updated Review on Nocardia Species: 2006-2021. Clin Microbiol Rev. 2022;35:e0002721.

Pérez-Gilaberte JB, García-Arceiz E, Viñuales-Aranda MD. Nocardia and Tuberculosis Pulmonary Coinfection Mimicking Pancoast Tumor in an Immunocompetent Host. Arch Bronconeumol. 2023;59:385-6.

McHugh KE, Sturgis CD, Procop GW, Rhoads DD. The cytopathology of Actinomyces, Nocardia, and their mimickers. Diagn Cytopathol. 2017;45:1105-15.

Muricy EC, Lemes RA, Bombarda S, Ferrazoli L, Chimara E. Differentiation between Nocardia spp. and Mycobacterium spp.: Critical aspects for bacteriological diagnosis. Rev Inst Med Trop Sao Paulo. 2014;56:397-401.

Wei M, Wang P, Yang C, Gu L. Molecular identification and phylogenetic relationships of clinical Nocardia isolates. Antonie Van Leeuwenhoek. 2019;112:1755-66.

Coussement J, Lebeaux D, El Bizri N, Claes V, Kohnen M, Steensels D et al. Nocardia polymerase chain reaction (PCR)-based assay performed on bronchoalveolar lavage fluid after lung transplantation: A prospective pilot study. PLoS One. 2019;14:e0211989.

Restrepo A, Clark NM. Infectious Diseases Community of Practice of the American Society of Transplantation. Nocardia infections in solid organ transplantation: Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation. Clin Transplant. 2019;33:e13509.

Mehta HH, Shamoo Y. Pathogenic Nocardia: A diverse genus of emerging pathogens or just poorly recognized? PLoS Pathog. 2020;16:e1008280.

Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev. 1994;7:213-64.

Arif M, Talon A, Sarma H, Munoz J, Charley E. Nocardia after COVID-19 Infection. Chest. 2021;160:A429.

Cockerill FR, Edson RS. Trimethoprim-sulfamethoxazole. Mayo Clin Proc. 1991;66:1260-9.

Colaneri M, Lombardi A, Morea A, Monzillo V, Mariani B, Marone M et al. An eight-year experience of Nocardia infection in Italy: does immunosuppression matter? New Microbiol. 2021;44:111-6.

Ortiz J, Jover F, Ortiz de la Tabla V, Delgado E. Pulmonary nocardiosis after covid-19 infection: case report and literature review. Rev Esp Quimioter. 2023;36:421-4.

Siddiqui SS, Sharma T, Khurana AK, Goyal A, Joshi D, Goel G, Khurana U, Kapoor N. Bronchoalveolar Lavage in Diagnostic Evaluation of Pulmonary Diseases- An Institutional Experience. J Cytol. 2023;40:68-74.

Downloads

Published

2023-08-31

How to Cite

Sesodia, K., Khosla, P., Taneja, V., & Dessai, R. (2023). Post COVID nocardiosis-an opportunistic enemy. International Journal of Research in Medical Sciences, 11(9), 3479–3481. https://doi.org/10.18203/2320-6012.ijrms20232815

Issue

Section

Case Reports