Pneumonia amidst the COVID-19 Pandemic: A Case Report

Abstract

Nocardiosis is an infection with increased morbidity and mortality and has the ability to cause localized or systemic suppurative disease in humans and animals. Pulmonary nocardiosis is a subacute or chronic necrotizing pneumonia caused by aerobic actinomycetes of the genus nocardia and rare in immune-competent patients. Clinical diagnosis of pulmonary nocardiosis is difficult owing to the similarity of its presentation with other respiratory pathogens that include actinomycetes members and Mycobacterium tuberculosis. The difficulty in diagnosing human nocardiosis in the lab arises from the fact that most laboratories do not adhere to the lengthy incubation times required for isolation of a Nocardia spp. culture.  The lack of clinical, laboratory and epidemiological data on the incidence of nocardiosis in humans undermines its significance as a potential pathogen. Here, we present a case of pulmonary nocardiosis in an older man who initially displayed symptoms similar to those in Covid 19 but was later diagnosed with the condition.  The patient has a past history of diabetes and myasthenia gravis on mycophenolate mofetil. Despite the fact that nocardiosis is widespread in immunocompromised individuals, the difficulties we encountered were in detecting a case with comparable radiological findings to Covid 19 pneumonia and the differences in therapy options between the two.