American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2017, 5(9), 248-251
DOI: 10.12691/ajmcr-5-9-6
Open AccessCase Report

Disseminated Nocardiosis in a Patient with Lepromatous Leprosy

Balakrishnan Valliyot1, Sarosh Kumar K1, Harikrishnan Mohan1, , Sarin S1, Kadeeja Beevi1 and Sudha Balakrishnan1

1Department of General Medicine, ACME-Pariyaram

Pub. Date: September 28, 2017

Cite this paper:
Balakrishnan Valliyot, Sarosh Kumar K, Harikrishnan Mohan, Sarin S, Kadeeja Beevi and Sudha Balakrishnan. Disseminated Nocardiosis in a Patient with Lepromatous Leprosy. American Journal of Medical Case Reports. 2017; 5(9):248-251. doi: 10.12691/ajmcr-5-9-6


Disseminated nocardiosis is a serious opportunistic infection with very high mortality, especially in individuals with defective cell mediated immunity. The use of immunosuppressant therapy is associated with increased risk of opportunistic infections and in south-east Asian countries where tuberculosis is widely prevalent, Nocardia is an often overlooked and under diagnosed pathogen, with clinically very similar presentations. Here we report a case of disseminated nocardiosis presenting as multifocal brain, in a patient with Lepromatous Leprosy, who was on immunosuppressive therapy for Type 2 Lepra reactions. An early diagnosis requires high index of suspicion and interventions like stereotactic brain surgery and is a determinant for positive clinical outcome.

brain abscess disseminated nocardiosis immunesuppresant therapy opportunistic infections leprosy nocardia

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Saubolle MA, Sussland D. Nocardiosis review of clinical and laboratory experience. Journal of clinical microbiology. 2003 Oct 1; 41(10): 4497-501.
[2]  Wilson JW. Nocardiosis: updates and clinical overview. InMayo Clinic Proceedings 2012 Apr 30 (Vol. 87, No. 4, pp. 403-407). Elsevier.
[3]  Dodiuk-Gad R, Cohen E, Ziv M, Goldstein LH, Chazan B, Shafer J, Sprecher H, Elias M, Keness Y, Rozenman D Cutaneous nocardiosis: report of two cases and review of the literature. Int J Dermatol. 2010 Dec; 49(12): 1380-5.
[4]  Kranick SM, Zerbe CS. Challenges in Clinical Neuroinfectious Disease: CNS Nocardiosis. Journal of neurovirology. 2013 Oct; 19(5): 505.
[5]  Xu Q, Zhan R, Feng Y, Chen J. Successful treatment of multifoci nocardial brain abscesses: a case report and literature review. Medicine. 2015 May; 94(19): e848.
[6]  Hathaway, Beulah M., and Kathleen N. Mason. “Nocardiosis: Study of fourteen cases.” The American journal of medicine 32.6 (1962): 903-909.
[7]  Kaddah RO, Khalil ME. MR Spectroscopy evaluation of white matter signal abnormalities of different non-neoplastic brain lesions. The Egyptian Journal of Radiology and Nuclear Medicine. 2016 Mar 31; 47(1): 233-42.
[8]  Baikie AG, Macdonald CB, Mundy GR. Systemic nocardiosis treated with trimethoprim and sulphamethoxazole. The Lancet. 1970 Aug 1; 296(7666): 261.
[9]  Moylett EH, Pacheco SE, Brown-Elliott BA, Perry TR, Buescher ES, Birmingham MC, Schentag JJ, Gimbel JF, Apodaca A, Schwartz MA, Rakita RM. Clinical experience with linezolid for the treatment of Nocardia infection. Clinical infectious diseases. 2003 Feb 1; 36(3): 313-8.
[10]  McAndrew GM. Cerebral nocardiosis. Postgraduate medical journal. 1965 Oct; 41(480): 639.
[11]  Nerune SM, Palur K. Cytological Diagnosis of Primary Cutaneous Nocardiosis in a Known Case of Lepromatous Leprosy, Syphilis and HIV. Journal of Krishna Institute of Medical Sciences (JKIMSU). 2016 Jul 1; 5(3).
[12]  Minero MV, Marín M, Cercenado E, Rabadán PM, Bouza E, Muñoz P Nocardiosis at the turn of the century. Medicine (Baltimore). 2009 Jul; 88(4): 250-61.