Diagnosis of an emerging Nocardia species infection by MALDI-TOF in a patient with tuberculosis

• Autores: Cámara Reyes, Ramón R., Díaz Carrión, Eddie G., Zúñiga Rosas, Marco A.
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Universidad Nacional Mayor de San Marcos
• Repositorio: Revistas - Universidad Nacional Mayor de San Marcos
• Lenguaje: español
• OAI Identifier: oai:revistasinvestigacion.unmsm.edu.pe:article/29147
• Enlace del recurso: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/29147
• Nivel de acceso: acceso abierto
• Materia: Nocardia; Mycobacterium tuberculosis; Polymerase Chain Reaction; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Reacción en Cadena de la Polimerasa; Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción

Nocardia infections exhibit diverse clinical manifestations, pulmonary nocardiosis (PN) is the most common. In countries with a high burden of MDR TB such as Peru, co-infection with Nocardia is possible. We report the case of a 91-year-old male with cough, malaise, and weight loss, initially treated for pulmonary tuberculosis (sputum BK positive) without improvement. Subsequent testing with MALDI-TOF identified Nocardia cyriacigeorgica in sputum, confirming coinfection with Mycobacterium tuberculosis sensitive to rifampin detected through real-time PCR. Rapid diagnostic tools such as PCR and MALDI-TOF enhance diagnostic precision; however, their interpretation must consider individual risk factors to avoid overtreatment and ensure an appropriate therapeutic regimen.