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Background <p>Disseminated nocardiosis is a rare and potentially fatal disease, with a higher incidence in immunocompromised patients, such as those living with human immunodeficiency virus (HIV) or hematological malignancies, including lymphoma. Information on <i>Nocardia</i> spp. infection in Venezuela is limited.</p> Case presentation <p>We present the case of a 62-year-old male patient, recently diagnosed with HIV, who exhibited prolonged fever and unintentional weight loss. Paraclinical tests revealed pancytopenia and a marked elevation of lactate dehydrogenase. Disseminated histoplasmosis was suspected, prompting a bone marrow (BM) aspirate. Culture and molecular studies for <i>Histoplasma</i> spp. and <i>Mycobacterium tuberculosis</i> in BM samples were negative. Antiretroviral therapy with tenofovir/lamivudine/dolutegravir was initiated, but the patient subsequently experienced clinical deterioration, including ascites, pericardial effusion, and respiratory failure. Post-mortem biopsy and immunohistochemistry identified non-Hodgkin’s lymphoma of B-cell lineage, and mycological culture of BM isolated <i>Nocardia farcinica</i>.</p> Conclusion <p>Disseminated nocardiosis may mimic histoplasmosis. <i>Nocardia</i> spp. infection should be considered in HIV patients, particularly in advanced stages of infection.</p>

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Disseminated nocardiosis in a patient with AIDS and B-cell non-Hodgkin’s lymphoma: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月6日

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  • Delvis R. Reverón,
  • David M. Flora-Noda,
  • Lily M. Soto,
  • Maribel Dolande,
  • Juan Frey,
  • Aleiram Chaurio,
  • Bárbara D. Ruiz-Alayón,
  • Jocays Caldera,
  • Fhabián S. Carrión-Nessi,
  • David A. Forero-Peña

摘要

Background

Disseminated nocardiosis is a rare and potentially fatal disease, with a higher incidence in immunocompromised patients, such as those living with human immunodeficiency virus (HIV) or hematological malignancies, including lymphoma. Information on Nocardia spp. infection in Venezuela is limited.

Case presentation

We present the case of a 62-year-old male patient, recently diagnosed with HIV, who exhibited prolonged fever and unintentional weight loss. Paraclinical tests revealed pancytopenia and a marked elevation of lactate dehydrogenase. Disseminated histoplasmosis was suspected, prompting a bone marrow (BM) aspirate. Culture and molecular studies for Histoplasma spp. and Mycobacterium tuberculosis in BM samples were negative. Antiretroviral therapy with tenofovir/lamivudine/dolutegravir was initiated, but the patient subsequently experienced clinical deterioration, including ascites, pericardial effusion, and respiratory failure. Post-mortem biopsy and immunohistochemistry identified non-Hodgkin’s lymphoma of B-cell lineage, and mycological culture of BM isolated Nocardia farcinica.

Conclusion

Disseminated nocardiosis may mimic histoplasmosis. Nocardia spp. infection should be considered in HIV patients, particularly in advanced stages of infection.