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Published 14 April 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.06.2008.0233]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Reminder of important clinical lesson

Pulmonary nocardiosis mimicking relapse of tuberculosis

Sajal De1, Prabha Desikan2

1 Bhopal Memorial Hospital & Research Centre, Pulmonary Medicine, Raisen Bye Pass Road, Karond Chowk, Bhopal, 462038, India
2 Bhopal Memorial Hospital & Research Centre, Dept of Microbiology, Raisen Bye Pass Road, Bhopal, 462038, India

Correspondence to:
Sajal De, sajalde{at}yahoo.com

SUMMARY

The present report concerns a case of pulmonary nocardiosis in an immunocompetent host. This patient was diagnosed as having smear positive pulmonary tuberculosis and received supervised antitubercular treatment for 6 months from a government run tuberculosis centre (Directly Observed Therapy, Short-Course (DOTS) centre). At 3 months after completion of treatment, she presented with fever and cough with posterior–anterior (PA) view chest x ray showing a cavitary lesion on left upper zone. She was subsequently diagnosed as having a case of pulmonary nocardiosis and responded to oral cotrimoxazole.


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