Nocardia is a rarely encountered opportunistic gram-positive bacterium that exhibits marked invasiveness and dissemination. Typically, acquired through trauma or inhalation, this pathogen primarily affects immunocompromised individuals and is a potentially life-threatening risk in severe cases. Nocardia otitidiscaviarum is a particularly rare subtype of Nocardia infection, and the occurrence of concurrent Aspergillus infection is extremely rare. In cases where both infections manifest concomitantly, rapid and accurate diagnosis is essential to facilitate the subsequent selection of appropriate anti-infective interventions. This paper reported the diagnostic and therapeutic experience in managing a case of pulmonary co-infection with Nocardia otitidiscaviarum and Aspergillus. The patient presented with an acute onset, rapid progression, and early manifestation of respiratory failure. The diagnostic process included respiratory pathogen culture and bronchoscopy, which was supplemented with targeted next-generation sequencing (tNGS). These comprehensive diagnostic modalities led to the identification of pulmonary co-infection with Nocardia otitidiscaviarum and Aspergillus. After adjustment of the antibiotic regimen, the patient's condition improved rapidly, culminating in a timely discharge.
诺卡菌是一种罕见的机会性革兰阳性杆菌，具有较强的侵袭性及播散性，主要通过创伤侵入或吸入方式感染，常导致免疫功能低下者患病，严重者可能危及生命。豚鼠耳炎诺卡菌感染是诺卡菌感染中比较少见的类型，合并曲霉感染更为罕见。当两种感染同时发生时，快速准确的诊断对于后续选择合适的抗感染治疗方案至关重要。本文报道了1例肺部豚鼠耳炎诺卡菌合并曲霉感染病例的诊治过程及救治体会。本例患者起病急，进展迅速，病初即并发呼吸衰竭，通过呼吸道病原菌培养联合支气管镜检查、病原体靶向测序（targeted next-generation sequencing，tNGS）诊断为肺部豚鼠耳炎诺卡菌合并曲霉感染，给予调整抗菌药物治疗后，病情迅速改善，好转出院。.