{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:29:48Z","timestamp":1790918988095,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by persistent airflow limitation. Infection with either <jats:italic>Mycobacterium tuberculosis<\/jats:italic> or <jats:italic>Nocardia<\/jats:italic> in COPD patients has been reported. However, co-infection with <jats:italic>Mycobacterium tuberculosis<\/jats:italic> and <jats:italic>Nocardia<\/jats:italic> is rare. Herein, we described such a patient with COPD in a primary hospital, and the diagnosis process.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 79-year-old female farmer with COPD was consecutively admitted to two hospitals with chief complaints of worsening cough, sputum and gasping since January10, 2022. Microbiological examination was not performed at the first hospital due to unknown reasons, and empirical antibiotic treatment was not effective. The patient was subsequently referred to our hospital. After screening the source of infection and the pathogen, she was diagnosed with tuberculosis. However, the patient did not benefit from antituberculosis treatment, with no remission of respiratory tract symptoms. Cerebrospinal fluid and bronchoalveolar lavage fluid specimens were subsequently sent for microbiological examination. The results indicated <jats:italic>Mycobacterium tuberculosis<\/jats:italic> and <jats:italic>Nocardia.spp<\/jats:italic>. After four days of bacterial culture, <jats:italic>Nocardia.spp<\/jats:italic> grew on medium, and <jats:italic>Nocardia.farcinica<\/jats:italic> was identified by the MALDI-TOF MS system and 16\u00a0s RNA. The patient was prescribed trimethoprim sulfamethoxazole (TMP\/SMX) in combination with anti-tuberculosis drugs to treat the co-infection. She showed gradual improvement and was discharged from the hospital on February 19, 2022. However, the follow-up results were unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Co-infection with <jats:italic>Nocardia<\/jats:italic> and <jats:italic>Mycobacterium tuberculosis<\/jats:italic> should be considered in COPD patients. Repeated microbiological and microscopy examinations are essential in primary hospitals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-023-02434-3","type":"journal-article","created":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T12:01:55Z","timestamp":1682164915000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Co-infection with Mycobacterium tuberculosis and Nocardia farcinica in a COPD patient: a case report"],"prefix":"10.1186","volume":"23","author":[{"given":"Yingzhu","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-0097","authenticated-orcid":false,"given":"Wei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,22]]},"reference":[{"key":"2434_CR1","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.2147\/COPD.S300789","volume":"16","author":"L Wu","year":"2021","unstructured":"Wu L, Lan N, Yang X. Effects of empirical glucocorticoid use on severe acute exacerbation of COPD during hospitalization. Int J Chron Obstruct Pulmon Dis. 2021;16:2419\u201331.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"6","key":"2434_CR2","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1111\/j.1469-0691.2005.01143.x","volume":"11","author":"F Ader","year":"2005","unstructured":"Ader F, Nseir S, Le Berre R, Leroy S, Tillie-Leblond I, Marquette CH, et al. Invasive pulmonary aspergillosis in chronic obstructive pulmonary disease: an emerging fungal pathogen. Clin Microbiol Infect. 2005;11(6):427\u20139.","journal-title":"Clin Microbiol Infect"},{"issue":"4","key":"2434_CR3","doi-asserted-by":"publisher","first-page":"e10138","DOI":"10.1371\/journal.pone.0010138","volume":"5","author":"M Inghammar","year":"2010","unstructured":"Inghammar M, Ekbom A, Engstr\u00f6m G, Ljungberg B, Romanus V, L\u00f6fdahl CG, et al. 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Nontuberculous mycobacterial and Nocardia infections mimicking pulmonary tuberculosis: a retrospective study of a general hospital patient population in China. J Med Microbiol. 2020;69(9):1145\u201350.","journal-title":"J Med Microbiol"},{"key":"2434_CR12","unstructured":"World Health Organization. Global tuberculosis report [EB\/OL].\u00a0https:\/\/www.who.int\/publications\/digital\/global-tuberculosis-report-2021. Accessed 14 Oct 2021."},{"key":"2434_CR13","doi-asserted-by":"crossref","unstructured":"Dong YH, Chang CH, Wu FL, Shen LJ, Calverley PMA, L\u00f6fdahl CG, et al. Use of inhaled corticosteroids in patients with COPD and the risk of TB and influenza: a systematic review and meta-analysis of randomized controlled trials. a systematic review and meta-analysis of randomized controlled trials. Chest. 2014;145(6):1286\u201397.","DOI":"10.1378\/chest.13-2137"},{"key":"2434_CR14","unstructured":"Modesto dos Santos V, Martins RR, Fachinelli LR, Araujo MC, dos Santos UM, Ribeiro KD. 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Eur J Pediatr. 2018;177(2):181\u201392.","DOI":"10.1007\/s00431-017-3044-3"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-023-02434-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-023-02434-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-023-02434-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T12:01:59Z","timestamp":1682164919000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-023-02434-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,22]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2434"],"URL":"https:\/\/doi.org\/10.1186\/s12890-023-02434-3","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,22]]},"assertion":[{"value":"22 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Ethics Committee of Department of Critical Care Medicine, The Traditional Chinese Medicine Hospital of Dianjiang County. The patients were informed of the purpose of the study, and verbal and written informed consents were obtained prior to the study. I confirm that all methods were performed in accordance with the relevant guidelines. All procedures were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"136"}}