A rare pneumonia in an immunocompetent adolescent - Pulmonary nocardiosis

Nocardia species are branching filaments of gram-positive bacteria that are omnipresent in soil and water. Sixteen species of Nocardia have been implicated in human infections. Nocardia infections commonly arise in the immunocompromised states including organ transplants, leukemia, HIV, steroid abuse, and autoimmune disease. Our patient, a 13-year-old male, reported to the out-patient department with chief complaints of right-sided pleuritic chest pain, cough, fever, shortness of breath, and cervical lymphadenopathy for 2 months. His computed tomography thorax scan showed a right upper lobe dense consolidation, aspiration cytology of which was inconclusive. Bronchoalveolar lavage revealed nocardiosis, with no intracranial involvement. He was treated with appropriate antibiotics and achieved significant improvement. The case is being reported as it is a rare infection in an immunocompetent adolescent.