A CASE REPORT ON PULMONARY NOCARDIOSIS IN AN IMMUNOCOMPETENT CHILD

Abstract

Genus Nocardia usually affects an immunocompromised patient. Predominantly, the infection involves the lungs followed by Central Nervous System. In the paediatric age group, 60% to 70% of cases occur due to an underlying immunocompromised state. Approximately 30% of immunocompetent children can also get infected with Nocardia and present as lymphocutaneous disease, orbital cellulitis, arthritis, or pneumonia A case of pulmonary infection from Nocardia in an immunocompetent patient is reported here. The case patient was a 14-year-old child who presented with chronic off-and-on cough with expectoration from 2 to 3 years. Sputum for AFB smear showed acid-fast bacilli whereas HRCT lung was normal and Mycobacterium tuberculosis was not detected on RT-PCR. Antibiotic coverage was given with Tab. Linezolid 600mg BD and the patient improved gradually. India is endemic for tuberculosis and the clinical presentation of Mycobacterium tuberculosis and Pulmonary nocardiosis overlaps, this case report highlights the importance of suspecting Nocardia spp. infection in such cases as the immunocompetent paediatric age group