Human
brucellosis is an
infectious disease caused by Brucella and is often misdiagnosed for atypical manifestations including
fever of unknown origin,
headache, weakness, among else.
Nocardiosis is a
zoonotic disease caused by the genus Nocardia, which usually spreads through the respiratory tract, skin, and digestive tract. Limited research has documented cases of
co-infection involving both Brucella and Nocardia pathogens in patients. A 55-year-old male was admitted to our hospital with intermittent high-grade
fever. Following sputum and blood cultures, as well as other laboratory examinations, the patient was diagnosed with concurrent
brucellosis and
nocardiosis. According to recommendations of previous studies and reports, the patient was successively treated with
levofloxacin,
doxycycline,
piperacillin sodium and
sulbactam sodium,
trimethoprim-sulfamethoxazole,
rifampicin, and
tigecycline, after which the patient recovered and was discharged. Brucella and Nocardia are both opportunistic pathogens and simultaneous
infection of Brucella and Nocardia is relatively rare. If patients continue to experience persistent
fever despite receiving empirical
antibiotic therapy, it becomes necessary to conduct examinations to identify potential atypical pathogens, including Brucella and Nocardia. Sputum staining, sputum culture, and blood culture are critical auxiliary examinations during clinical practice. The treatment plan should be selected based on guidelines and the individual patient's condition. Regular reevaluation should be conducted, and
antimicrobial agents should be adjusted accordingly.