title: A Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient.
abstract: Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Minkyu
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Juri
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Junhung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Dongkyu
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Infectious Diseases, Seoul Metropolitan Government Seobuk Hospital, Seoul, Korea.
authors.forename: Heejung
authors.initials: H
authors.lastname: Yoon
keywords: Nocardia; Pneumonia; Trimethoprim, Sulfamethoxazole Drug Combination