Title: Nocardiosis: Case Series in a Tertiary Care Center in Central Kerala

Authors: Dr Chris Mary Antony, Dr Kiran Jose, Dr Tanya Tony Mampilly, Dr Vibi Varghese, Dr Neethu John, Dr Aswathy Varghese, Dr Anu Mary Antony, Dr Lancy Justus

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.99

Abstract

Nocardiosis is a localised or disseminated opportunistic infection caused by an aerobic gram positive filamentous organism that usually affects immunocompromised individuals. There are more than 100 species of nocardia identified with more than 30 species causing clinical disease in humans. It is a rare opportunistic infection. We are reporting 4 cases of nocardiosis diagnosed with laboratory confirmation including species identification at Govt. Medical College, Ernakulam within a short period of 6 months from August 2019 to January 2020.One case of pulmonary nocardiosis from which Nocardia farcinica was isolated from sputum sample. Another was a case of disseminated nocardiosis and the isolate was obtained from blood sample. Third one was a HIV positive patient with axillary abscess from whom Nocardia brasiliensis was isolated from aspirated pus sample. Fourth one was a patient with soft tissue infection from whom Nocardia cyriacigeorgia was isolated from the aspirated pus sample. All the isolates obtained from culture of the clinical samples were confirmed with Vitek-2 and species identification was made by MALDI-TOF. All the four patients had undergone parenteral administration of combination therapy with Ceftriaxone, Amikacin and IMIpenem followed by oral Co-trimoxazole. Three patients survived and one patient with disseminated nocardiosis expired after 1 month inspite of effective treatment with several antibiotics.

Keywords: Nocardia species nocardiosis, immunocompromised individual.

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Corresponding Author

Dr Lancy Justus

Professor of Microbiology, Govt. Medical College, Ernakulam