Pulmonary infection caused by Nocardia cyriacigeorgica and influenza A virus coinfection in an immunocompetent patient: A case report.
Zhengfan Yu, Yanmei Zhang, Lijie Qiu et al.
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Case in brief
A 60-year-old immunocompetent man without reported underlying pulmonary disease presented with recurrent cough and sputum production over 5 months, worsening respiratory symptoms, and recent fever. Nocardia cyriacigeorgica was identified in sputum and bronchoalveolar lavage testing, while influenza A virus was detected by nucleic acid testing. He received peramivir and combination antibiotics during hospitalization, followed by maintenance oral trimethoprim-sulfamethoxazole. Follow-up showed clinical improvement and gradual reduction of lung lesions on chest CT.
What made this case unusual
Pulmonary nocardiosis occurred in an immunocompetent patient without the usual reported risk factors, alongside influenza A infection.
Diagnostic / clinical pearl
Pulmonary nocardiosis can present without typical risk factors, and its nonspecific symptoms and varied imaging findings may complicate diagnosis; microbiological testing was key in this case.