{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:05:02Z","timestamp":1773849902965,"version":"3.50.1"},"reference-count":23,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Nocardiosis is a rare opportunistic infection mostly affecting the lungs, brain, or skin of immunocompromised individuals. Most pulmonary nocardiosis patients present with nonspecific clinical features such as productive cough, exertional dyspnea, and fever. The disease is uncommonly suspected, especially in tuberculosis-endemic regions, and clinical diagnosis is often delayed, resulting in high mortality. Pulmonary nocardiosis in apparently immunocompetent individuals is uncommon. Here, we present the case of an elderly gentleman with a background history of poorly controlled diabetes but no history of systemic steroid use who presented with worsening symptoms of chronic obstructive pulmonary disease in the form of productive cough and dyspnea. The patient had diffuse crepitations in bilateral lung fields and an arterial oxygen saturation of 86% at admission. Sputum microscopy revealed gram-positive filamentous bacteria that could be successfully cultured and identified as <jats:italic>Nocardia amamiensis<\/jats:italic> on 16S ribosomal RNA sequencing. Contrast-enhanced computed tomography of the lungs revealed cavitary nodules and consolidation. The patient responded well to treatment with specific antibiotics based on sensitivity patterns. Because of the nonspecific clinical and radiological findings in pulmonary nocardiosis, a high index of suspicion is required, especially in tuberculosis-endemic regions.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0284","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T11:22:09Z","timestamp":1694431329000},"page":"1137-1140","source":"Crossref","is-referenced-by-count":8,"title":["Case Report: Nocardia amamiensis Infection Leading to Worsening of Chronic Obstructive Pulmonary Disease Symptoms in an Elderly Man"],"prefix":"10.4269","volume":"109","author":[{"given":"Ahalya","family":"Kanakan","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Upinder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prity","family":"Narwade","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zinnu","family":"Rain","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishan","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sankha Shubhra","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Microbiol Mol Biol Rev","first-page":"1","article-title":"Taxonomy, physiology, and natural products of 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Dis","first-page":"1","article-title":"Pulmonary infections caused by emerging pathogenic species of Nocardia.","volume":"2019","author":"Manoharan","year":"2019"},{"key":"b21","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"759","article-title":"Nocardia colonization in contrast to nocardiosis: a comparison of patients\u2019 clinical characteristics","volume":"39","author":"Margalit","year":"2020"},{"key":"b22","series-title":"Clin Microbiol Infect","first-page":"550","article-title":"How do I manage nocardiosis?","volume":"27","author":"Margalit","year":"2021"},{"key":"b23","series-title":"Can Respir J","first-page":"1","article-title":"Pulmonary nocardiosis: review of cases and an update","volume":"2016","author":"Shariff","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and 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