Pulmonary Nocardiosis as an Opportunistic Infection in COVID-19

Marc Laplace; Thomas Flamand; Ciprian Ion; Simon Gravier; Mahsa Mohseni Zadeh; Dominique Debriel; Olivier Augereau; Guillaume Gregorowicz; Martin Martinot

doi:10.12890/2022_003477

Pulmonary Nocardiosis as an Opportunistic Infection in COVID-19

Eur J Case Rep Intern Med. 2022 Aug 22;9(8):003477. doi: 10.12890/2022_003477. eCollection 2022.

Authors

Marc Laplace¹, Thomas Flamand¹, Ciprian Ion¹, Simon Gravier¹, Mahsa Mohseni Zadeh¹, Dominique Debriel², Olivier Augereau², Guillaume Gregorowicz², Martin Martinot¹

Affiliations

¹ Department of Infectious Diseases, Hôpitaux Civils de Colmar, Colmar, France.
² Department of Microbiology, Hôpitaux Civils de Colmar, Colmar, France.

Abstract

Secondary bacterial pneumonia infection is frequent in COVID-19 patients. Nocardia are responsible for opportunistic pulmonary infections especially after steroid treatment. We describe a case of pulmonary nocardiosis following critical COVID-19 pneumonia in an 83-year-old male. Two weeks after initiation of dexamethasone 6 mg/L, the patient developed a new episode of acute dyspnea. The sputum cultures identified Nocardia cyriacigeorgica. In spite of intravenous imipenem and cotrimoxazole treatment the patient died. Physicians should be aware of the possibility of nocardiosis in case of deterioration of respiratory status of severe COVID-19 inpatients and perform Nocardia evaluation. This evaluation requires prolonged culture.

Learning points: Nocardia are responsible for opportunistic pulmonary infections after steroid treatment.We describe a case of pulmonary nocardiosis following critical COVID-19 pneumonia.Physicians should be aware of the possibility of secondary nocardiosis in COVID-19 inpatients.

Keywords: COVID-19; Nocardia cyariacigerogica; SARS-CoV-2; nocardiosis; opportunistic infection.