Nocardia pseudobrasiliensis Co-infection in SARS-CoV-2 Patients

Abstract

During the SARS-CoV-2 pandemic, few cases of Nocardia spp. co-infection have been reported during or after a COVID-19 infection. Nocardia spp. are gram-positive aerobic actinomycetes that stain partially acid-fast, can infect immunocompromised patients, and may cause disseminated disease. We present the case of a 52-yearold immunocompromised man who developed Nocardia pseudobrasiliensis pneumonia after a SARS-CoV-2 infection, and we summarize the current literature for nocardiosis and SARS-CoV-2 co-infections. Nocardia spp. infection should remain on the differential diagnosis of pneumonia in immunocompromised hosts, regardless of other co-infections. Sulfonamide-carbapenem combinations are used as empiric therapy for nocardiosis; species identification and susceptibility testing are required to select the optimal treatment for each patient.