Co-infection with Mycobacterium and 20% acid-fast Nocardia in an immunocompetent patient – A case report

Abstract

Nocardiosis is an opportunistic infectious disease in immunocompromised individuals, which may be fatal and in people with healthy immune systems, which is reported as a case. Mixed infections with Nocardia and Mycobacterium tuberculosis complex (MTBC) are rare. We are reporting a case of co-infection with Nocardia spp. and MTBC in an immunocompetent patient presenting with neck swelling. Interestingly, in this case, the primary identification of Nocardia was done using 20% H2SO4 as decolorizer for Ziehl–Neelsen staining. The patient was given first-line anti-tubercular treatment for the first 2 months as an intensive phase, followed by isoniazid and rifampicin for an additional 4 months, with a total of 6 months treatment, along with linezolid (600 mg twice daily for 15 days). The patient subsequently improved.