Disseminated Nocardia beijingensis Infection in an Immunocompetent Patient.

ABSTRACT

Nocardia is a genus of aerobic, non-motile and non-spore-forming filamentous branching bacteria with fragmentation into bacillary or coccoid forms. Infections caused by Nocardia often occur in immunocompromised hosts and are potentially life-threatening. Nocardia beijingensis has rarely been reported to cause infection in immunocompetent hosts. We present a case of disseminated infection due to Nocardia beijingensis in a patient with no known medical comorbidities, who presented with new-onset seizure. Another interesting finding in our case is that our patient did not have any pulmonary symptoms despite chest CT showing the pulmonary system as the likely primary site of infection. As per our literature review, this is the seventh reported case of infection due to Nocardia beijingensis in an immunocompetent host. LEARNING POINTS To recognize Nocardia beijingensis, a slow-growing weakly acid-fast filamentous bacteria commonly causing opportunistic infections in immunocompromised hosts, as an emerging pathogen in immunocompetent patients.Tissue biopsy with Gram staining showing variable filamentous bacteria and confirmation of species using restriction enzyme analysis and 16S rRNA analysis is needed to establish a diagnosis of infection.Trimethoprim/sulfamethoxazole has been successfully used to treat infection due to Nocardia beijingensis.