BMJ Case Reports 2013; doi:10.1136/bcr-2012-008076

Primary abdominal nocardiosis masquerading as tubercular pelvic inflammatory disease in an immunocompetent individual

  1. Mukhyaprana Prabhu1
  1. 1Department of Medicine, Kasturba Medical College, Manipal, Karnataka, India
  2. 2Department of Cardiology, Kasturba Medical College, Manipal, Karnataka, India
  1. Correspondence to Dr G Vivek, vivekgraman{at}


We report the case of a 30-year-old housewife who presented with fever and lower abdominal pain, and was diagnosed with an adnexal collection. Initial evaluation was suggestive of tubercular pelvic inflammatory disease (PID). Subsequently, from a culture of pus aspirated from the collection grew out Nocardia species. She was treated with amikacin and cotrimoxazole and made a complete recovery. Clinical and laboratory evaluation for immunosuppression was negative. Primary abdominal nocardiosis is an unusual cause for PID and an important differential diagnosis for tuberculosis.

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