诺卡氏菌是一种细菌,可在免疫受损和免疫活性宿主中引起感染。它是一种专性的空气器,常见于环境中。肺诺卡病可能表现为肺炎,支气管内炎性肿块,肺脓肿,和连续延伸的空洞性疾病,导致积液和脓胸。我们介绍了一例75岁的2型糖尿病男性患者的肺诺卡尼病。患者表现为双侧肺炎和缺氧,氧饱和度为85%。痰样本被送到微生物实验室进行测试。用1%H2SO4耐酸染色显示耐酸分支丝状棒,但是诺卡氏菌无法在培养中分离。对样品进行16SrRNA基因测序,将病原体鉴定为诺卡氏菌。痰的培养没有生长任何病原微生物,血培养是无菌的。不幸的是,由于建议患者进行插管,因此患者在没有医生建议的情况下离开了医院。患者无法生存,离开医院后第二天死亡。N.wallacei可能是致命的,并在免疫抑制和免疫功能正常的患者中引起播散性感染。在世界各地的文献中仅报道了8例N.wallacei病例报告。我们的病例是来自印度的第一个病例报告。
Nocardia is a type of bacteria that can cause infections in both immunocompromised and immunocompetent hosts. It is an obligate aerobe and is commonly found in the environment. Pulmonary nocardiosis may present as pneumonia, endobronchial inflammatory masses, lung abscess, and cavitary disease with contiguous extension, leading to effusion and empyema. We present a case of pulmonary nocardiosis in a 75-year-old male patient with type 2 diabetes mellitus. The patient presented with bilateral pneumonia and hypoxia with an oxygen saturation of 85%. Sputum samples were sent to the microbiology laboratory for testing. Acid-fast staining with 1% H2SO4 showed acid-fast branching filamentous rods, but Nocardia could not be isolated in culture. The sample was subjected to 16S rRNA gene sequencing, which identified the pathogen as Nocardia wallacei. The culture of the sputum did not grow any pathogenic organisms, and the blood culture was sterile. Unfortunately, the patient left the hospital against medical advice as he was advised for intubation. The patient could not survive and died the next day after leaving the hospital. N. wallacei can be fatal and cause disseminated infection in both immunosuppressed and immunocompetent patients. Only eight case reports of N. wallacei have been reported in the literature from various parts of the world. Our case is the first case report of N. wallacei from India.