CASE REPORT
Nocardia Lymphadenitis and Encephalitis in Immunocompromised Patient: A Case Report
Rizaldy Taslim Pinzon1, 2, *, Tillandsia Filli Folia Primastuti1
Article Information
Identifiers and Pagination:
Year: 2023Volume: 17
E-location ID: e1874205X2303180
Publisher ID: e1874205X2303180
DOI: 10.2174/011874205X254011230922043119
Article History:
Received Date: 28/03/2023Revision Received Date: 26/06/2023
Acceptance Date: 17/07/2023
Electronic publication date: 30/10/2023
Collection year: 2023
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Nocardiosis-related HIV usually appears in immunocompromised patients, which is caused by Nocardia sp. Although a number of reports describe pulmonary forms of nocardiosis in HIV-positive patients, lymphadenitis and encephalitis due to this organism are rare entities. Our preliminary search has only found a few cases reported in the literature. Unless investigations like gram stain and culture for Nocardia are specifically done, the infection is often mistaken for tuberculosis. We have herein reported a case of Nocardia lymphadenitis and encephalitis in an HIV-positive patient.
Case Presentation:
A 33-year-old male presented fever, progressive weakness in the right side of the body, multiple lesions on the oral cavity, and left colli lesions. Physical examination found GCS as E4 M6 V uncounted, hypertonic and increased physiology reflexes on the right extremity without pathologic reflexes, meningeal signs, and all cranial nerves as normal. The laboratory test result was HIV-positive with CD4+ 7 cells/μL and Nocardia sp. on histopathology. A plain head computed tomography (CT) scan showed a hypodense lesion in the fronto-temporo-parieto-occipital sinistra region, and vasogenic edema. The patient was administered antiretroviral (ARV) therapy and antibiotics for nocardiosis lymphadenitis.
Conclusion:
A rare case of Nocardia lymphadenitis has been reported in this paper, and the physician must be aware of nocardiosis in HIV patients with neurological deficits.
