Co-infection of Nocardia otitidiscaviarum and Mycobacterium tuberculosis in an immunocompetent elderly patient with chronic obstructive pulmonary disease: A rare case from North India

Chronic obstructive pulmonary disease (COPD) patients are susceptible to various bacterial and viral respiratory infections due to jeopardized structural and immunological defense mechanism along with long term or intermittent local corticosteroid administration. COPD is a common susceptibility factor for both Mycobacterium tuberculosis (MTB) and Nocardia spp. Herein, we report a case of co-infection of pulmonary nocardiosis and pulmonary tuberculosis (PTB) in a 75-year-old man with COPD. Infections due to Nocardia otitidiscaviarum remain infrequently reported. Concurrent PTB with nocardiosis may have devastating outcomes and may be missed. Hence, early diagnosis and initiation of therapy are crucial in both Tuberculosis and Nocardiosis.