A rare case report of pulmonary nocardiosis mimicking as lung malignancy

Pulmonary nocardiosis is a rare infectious disorder mainly affecting immunocompromised patients. It may remain cryptic which gradually progresses in its course. Our patient was a 37 years old immunocompetent female who presented with radiological picture of left upper lobe opacification. She was treated with empirical anti tuberculosis treatment outside, no radiological improvement seen. After she reported here, she was evaluated with bronchoscopy with biopsy and bronchial wash culture showed Nocardia species. She was managed with trimethoprim-sulphamethoxazole and amikacin with regular follow up for 6 months. She had radiological resolution and clinical improvement after 4 months of treatment. Hence we made the diagnosis of this rare infection in immunocompetent individual and successfully treated her, which was mistreated as pulmonary tuberculosis elsewhere.