• Xiaobin Wang, Hongjun Yang, Yunbo Xie, and Xuejiao Xian.
• Department of General Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province, China.
• Medicine (Baltimore). 2024 Jan 5; 103 (1): e36402e36402.

RationaleMembers of the genus Nocardia brasiliensis are Gram-positive, aerobic bacteria and exist ubiquitously in most environments. In recent years, the incidence of Nocardia brasiliensis has increased significantly and become a global concern. It may be predominantly caused pulmonary infections in immunocompromised hosts. Interestingly, however, we found that it can be present not only on immunocompromised hosts, but also to infect patients with a normal immune system.Patient ConcernsWe report a very rare case of a 49-year-old immunocompetent man with disseminated Nocardia brasensis pneumonia. He had a fever for 14 days (maximum temperature about 38°C) and a history of mass rupture.DiagnosesSevere Disseminated Nocardia brasiliensis pneumonia with normal immune function.InterventionsNo.OutcomesThe patient was finally diagnosed with Severe Disseminated Nocardia brasiliensis pneumonia and received compound sulfamethoxazole treatment for 4 months.Lessons SubsectionsOur report highlights when cold pus appears in soft tissues such as the lower limbs, neck, nose, scalp, etc, should prompt timely evaluation and biopsy for definitive diagnosis. Be alert to a normally immunocompetent, disseminated Nocardia brasiliensis infection. Early recognition and effective treatment are necessary conditions for successful results. This would allow for better disease prognostication while enabling physicians to develop more effective treatment strategies.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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