![]() ![]() Complete resolution of the lesion at four months of treatment with TMP-SMX and no complaints Sputum samples taken at one and two months of follow-up were negative. Discharged with advice to continue TMP-SMX for six mths and to come for follow-up Sputum was negative after one wk of treatment. Discharged with advice to continue TMP-SMX for six months and to come for follow-up Patient expired after six days of admissionĭischarged with advice to continue TMP-SMX for six months and to come for follow-up Gram positive branching filamentous rods with beadsĪcid fast branching filamentous rods with beadsĬulture-negative after seven days of incubation ![]() Left lower lobe collapse with consolidation Persistent symptoms of fever, loss of appetite, and mucopurulent sputum for two months after ATT course Table 1 shows the details of the cases.īreathlessness and increased cough with sputum for 4-5 days and loss of weight and loss of appetiteīreathlessness and cough with sputum for 20 years acutely increased for two weeks and fever for 1 weekīreathlessness and cough with sputum for 15 daysīreathlessness and cough with sputum for three months, intermittent fever for three months, and loss of weight Two of these were followed up and were completely free of symptoms, and their sputum was negative on smear and culture. Three were discharged and advised to continue TMP-SMX for six months. Patients were treated with trimethoprim-sulfamethoxazole (TMP-SMX) along with other antibiotics like amikacin and imipenem/meropenem. It was isolated on sheep blood agar from four cases. Sputum samples from four and bronchial alveolar lavage, bronchial aspirate, and sputum from one case showed Gram-positive filamentous branching rods with beaded appearance on Gram's staining and acid fast branching filamentous rods with beaded appearance on modified Ziehl-Neelsen staining suggestive of Nocardia. All were immunocompromised with four of them having the chronic obstructive pulmonary disease (COPD) with tuberculosis and one with COPD and diabetes mellitus. They were admitted with complaints of breathlessness and increased cough with sputum production from a week to 3-month duration. In the present study, five cases of pulmonary nocardiosis (PN), four males and one female, were encountered among patients attending Vallabhbhai Patel Chest Institute, a tertiary care respiratory diseases hospital in Delhi, India. Patients with disseminated or severe nocardiosis should be treated with combination therapy with two or more active agents. Early detection can lead to the prompt initiation of treatment and reduced mortality in these patients. So physicians and laboratory staff should be aware of this and try to diagnose it. Nocardiosis is encountered in parts of the world even where it is not endemic due to increased world travel. The disease was cured in three patients, and two died due to other comorbid conditions leading to complications. They were treated with the trimethoprim-sulfamethoxazole combination. Smears were prepared from the samples and were stained and cultured. Microbiology laboratory processed the clinical samples from patients with respiratory infections. Inhalation of Nocardia leads to pulmonary disease. Nocardia, a branching, filamentous bacteria, is widely distributed in the environment and can cause human infection in immune-compromised hosts. ![]()
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