Pulmonary Nocardiosis—A Mimicker of Tuberculosis in Human Immunodeficiency Virus Patients: Two Case Reports

REPORTtuberculosis, and Pneumocystis pneumonia were kept under the differential and he was started on co-trimoxazole, broad-spectrum antibiotics, and liposomal amphotericin.His chest computed tomography (CT) scan showed cavitary lesions in bilateral upper lobes and bilateral extensive ground glass opacities in the rest of the lung fields.A revised differential of Pneumocystis pneumonia with probable coexisting fungal, nocardial, or tubercular infection was made.His sputum samples tested negative for acid-fast bacilli (AFB) and Mycobacterium tuberculosis (Mtb) GeneXpert and fungal stains did not reveal any fungal cells/hyphae.He was on treatment with third-generation cephalosporin, macrolides, and co-trimoxazole for Nocardia and Pneumocystis with glucocorticoids and antifungal therapy.He had a fair response to therapy for the first 2 days, however by day 3 he had a progression of symptoms in form of severe