Nocardia Nova bacteremia and viral pneumonia in a breast cancer patient post modified radical mastectomy: a case report.

BACKGROUND

Nocardia nova (N. nova) is a Gram-positive aerobic actinomycete and a rare pathogen that can cause severe infections, particularly in immunocompromised patients.

CASE PRESENTATION: We report here a rare case of N. nova bacteremia combined with viral pneumonia in a 54-year-old woman who underwent a modified radical mastectomy for breast cancer. Post-surgery, she developed high fever and lung inflammation. Initial empirical therapy with levofloxacin was administered for the pulmonary infection. Upon identification of N. nova through blood cultures and antibiotic susceptibility testing (AST), treatment was switched to trimethoprim-sulfamethoxazole (TMP-SMX) and imipenem/cilastatin, which led to initial improvement. However, the patient relapsed and required an additional six months of antibiotics to achieve full recovery.

CONCLUSIONS

Establishing a diagnosis of nocardiosis is a precondition for successful antibiotic therapy. Nocardia bacteremia is a rare event, but it can be confirmed through blood cultures. Our report underscores the pathogenic potential of Nocardia species in patients with underlying conditions, highlighting the critical importance of prompt diagnosis and targeted treatment, especially in postoperative cancer patients at risk for co-infections.