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Nocardia otitidiscaviarum pneumonia in an immunocompetent host
Haroon Yousaf1, 2, Irfan Saddique3
1Theda Clark Hospital, Neenah, WI, USA.
2Shifa College of Medicine, Islamabad, Pakistan.

doi:10.5348/ijcri-2012-09-181-CR-11

Address correspondence to:
Haroon Yousaf
Theda Clark Hospital, 130 2nd Street
Neenah, WI, 54956
USA
Phone: 920-729-3100
Email: drhy@hotmail.com

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How to cite this article:
Yousaf H, Saddique I. Nocardia otitidiscaviarum pneumonia in an immunocompetent host. International Journal of Case Reports and Images 2012;3(9):39–41.


Abstract
Introduction: Nocardiosis is typically regarded as an opportunistic infection, but approximately one-third of infected patients are immunocompetent. We herein report a case of immune competent female with pulmonary N. otitidiscaviarum infection in whom complete cure was provided with a seven months of antibiotic combination including trimethoprim sulfamethaxazole.
Case Report: A rare case of Nocardia otitidiscaviarum pneumonia, in an otherwise healthy 44-year-old woman who complained of febrile illness associated with sore throat, dry cough, myalgia and diarrhea. She had never been a smoker. Her clinical symptoms showed a rapid deterioration in the two weeks before admission, despite a course of oral antibiotics. Gram-staining of her sputum taken at the time of his admission showed the presence of gram-positive branching filamentous bacilli. Sputum culture and PCR confirmed the diagnosis of Nocardia otitidiscaviarum. The patient was treated with a combination of antibiotics and showed excellent clinical and radiological response one month after treatment initiation.
Conclusion: The majority of patients with nocardial infection are immunocompromised, most often with cell-mediated abnormalities. However, nocardiosis should always be considered in the differential diagnosis of indolent pulmonary disease even in immunocompetent patients.

Key Words: Nocardia otitidiscaviarum, Pneumonia, PCR


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Author Contributions:
Haroon Yousaf – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Irfan Saddique – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Source of support:
None
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© Haroon Yousaf et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)