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Case Study | Microbiology | Volume 15 Issue 7, July 2026 | Pages: 484 - 485 | India
Pulmonary Nocardiosis and Tuberculosis Co-infection: A Case Report of a Silent Invader in an Immunocompromised Patient
Abstract: Background: Pulmonary nocardiosis is an uncommon but life-threatening infection caused by aerobic actinomycetes of the genus Nocardia. It is frequently misdiagnosed as tuberculosis (TB) or fungal infection due to overlapping clinical and radiological features. Early microbiological identification is critical for appropriate management. Case Presentation: A 40-year-old female with a history of childhood pulmonary TB presented with a one-month history of cough, expectoration, generalized weakness, and progressive dyspnoea. Chest X-ray revealed bilateral fluffy opacities. Endotracheal tube aspirate showed thin, branching, filamentous gram-positive bacilli and weakly acid-fast filaments on modified Ziehl?Neelsen (ZN) stain (1% sulfuric acid). Culture on blood agar and Lowenstein?Jensen medium yielded dry, chalky-white colonies, identified by MALDI-TOF-MS as Nocardia cyriacigeorgica. Notably, sputum CBNAAT was also positive, indicating pulmonary TB reactivation. Conclusion: This case highlights the necessity of thorough microbiological evaluation- including modified acid-fast staining- to diagnose mixed pulmonary infections. Coordination between clinicians and microbiologists is essential for early detection and targeted therapy.
Keywords: Pulmonary nocardiosis, Nocardia Cyriacigeorgica, Tuberculosis reactivation, Microbiological diagnosis
How to Cite?: Dr. Kripa Tony, Dr. Sanjay Jain, Dr. Rushna Wazahat, Dr. Kapil Singh, Dr. Shillpa Arora, "Pulmonary Nocardiosis and Tuberculosis Co-infection: A Case Report of a Silent Invader in an Immunocompromised Patient", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 484-485, https://www.ijsr.net/getabstract.php?paperid=SR26703145419, DOI: https://dx.doi.org/10.21275/SR26703145419