Disseminated nocardiosis masquerading as abdominal tuberculosis

A 32-year-old patient was admitted with a communityacquired pneumonia. She had clinical evidence of AIDS and chest X-ray features consistent with pulmonary tuberculosis. While in the ward she developed an acute abdomen necessitating laparotomy; at which a diagnosis of abdominal tuberculosis was made. Sputum and intraoperative pus specimens grew a multiresistant Nocardia brasiliensis. Microbiological investigations for tuberculosis were negative. The patient died after a short ICU admission from multiple organ dysfunction syndrome