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Case of coexisting Nocardia cyriacigeorgica and Aspergillus fumigatus lung infection with metastatic disease of the central nervous system
  1. Moni Roy1,2,
  2. Rone-Chun Lin3 and
  3. John Joseph Farrell3,4
  1. 1Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
  2. 2OSF Saint Francis Medical Center, Peoria, Illinois, USA
  3. 3Internal Medicine, Section of Infectious Diseases, University of Illinois college of medicine at Peoria, Peoria, Illinois, USA
  4. 4OSF System Laboratory, Peoria, Illinois, USA
  1. Correspondence to Dr Moni Roy; moniroy27{at}


Nocardiosis is a rare opportunistic gram-positive bacterial infection. The genus Nocardia consists of non-motile, aerobic, non-spore-forming, catalase-positive, filamentous-branching bacteria with fragmentation into coccoid or bacillary forms. Opportunistic infections due to Nocardia are reported in immunocompromised patients. Aspergillus fumigatus is a conidia forming fungus that can be found in soil, plant matter and dust, causing invasive pulmonary and disseminated infection in immunocompromised patients. Both Nocardia cyriacigeorgica and A. fumigatus are known to cause pulmonary infection with metastatic dissemination to the central nervous system. We present a case of Nocardia and Aspergillus co-infection in a patient who presented within a few days of initiation of immunosuppressants for suspected systemic lupus erythematosus.

  • drugs: infectious diseases
  • TB and other respiratory infections

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  • Contributors MR and RL conceptualised the research article. MR wrote the initial manuscript, performed data collection, performed image collection and editing. RL and JJF reviewed and edited the final manuscript. All authors reviewed the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.