Nocardia farcinica as a Cause of Complicated Chronic Suppurative Otitis Media: A Case Report

Abstract

Nocardia belongs to the order Actinomycetales suborder Corynebacteriaceae, family Nocardiaceae. It causes infections mostly in immunocompromised individuals. It primarily causes pulmonary infections, followed by central nervous system infections, cutaneous and disseminated infections. Cutaneous infections are reported in immunocompetent individuals also. Because of the growth characteristics, it is difficult to recover the organisms in culture. The recent advanced molecular technology has made identification of the organism to species level possible. Chronic Suppurative Otitis Media (CSOM) due to Nocardia spp is rarely reported. Here, authors report a case of CSOM caused by Nocardia farcinica in a 47-year-old female. The patient was on steroid therapy for bronchial asthma. Culture of ear discharge isolated Nocardia spp, identified as Nocardia farcinica by mass spectrometry. Appropriate antibiotic treatment was administered and good treatment response was obtained. Early diagnosis and appropriate antibiotic treatment is critical for nocardial infections. Difficulty in recovering and identifying the organism, with delay in initiating appropriate treatment can result in poor prognosis and treatment failure.