Pulmonary Nocardiosis—A Mimicker of Tuberculosis in Human Immunodeficiency Virus Patients: Two Case Reports

Abstract

Background: Nocardia is a gram-positive weakly acid-fast bacterium causing atypical pneumonia in an immunocompromised setting. A mimicker of pulmonary tuberculosis, presenting as cavitating lesions of the lung. It presents with suppurative disease localized to skin and subcutaneous tissue in immunocompetent individuals. It is a rare opportunistic infection in HIV patients with CD4 Nocardia requires the isolation of the organism from invaded tissue and can be stained on the Gram and modified acid-fast stains. Case Description: We report two cases of severe pulmonary nocardiosis diagnosed to have HIV infection on presentation with CD4 counts 3. Conslusion: We conclude that for patients presenting with subacute cavitating or interstitial pneumonia with immunocompromised status and HIV patients with low CD4 counts, a diagnosis of nocardiosis should be suspected along with tuberculosis and fungal infections.

Keywords

• human immunodeficiency virus and acquired immunodeficiency syndrome
• nocardiosis
• pneumonia