Disseminated nocardiosis caused by Nocardia vulneris in a macroglobulinemia patient

Headings Background : This is a case of a human disseminated nocardiosis caused by Nocardia vulneris which made the patient presenting with fever, cough, shortness of breath, muscle pain and multiple tubercle. Methods: Bacterial culture the blood, sputum, lung rinses and scalp pus samples of the patient, Nocardia vulneris was isolated and identified using the 16s ribosomal RNA gene sequence sequence data. and determine the sensitivity of the isolated bacteria to antibiotics and analysis of the strain's antibiotic treatment. Results: The isolated was identified as Nocardia brasiliensis, which was resistant to ciprofloxacin, but susceptible to amikacin, gentamicin, tobramycin, linezolid, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic, moxifloxacin, ceftriaxone, cefotaxim, imipenem. The patient recovered and his condition remained stable by combinations with linezolid, amikacin and trimethoprim-sulfamethoxazole. Conclusions: This is the first case report of disseminated nocardiosis caused by Nocardia vulneris, and the current case was treated successfully with linezolid, amikacin and trimethoprim-sulfamethoxazole. Clinicians should be aware of its diagnostic, and the MIC value of the drug sensitivity test should be concerned when there is a wide choice of medicines, for the disseminated cases which are diagnosed definitely should be treated with at least 12 months of antimicrobial therapy, bacteriological examination and antimicrobial susceptibility testing should be performed repeatedly.