Fatal Nocardia farcinica bacteremia in a patient with lung cancer.

Nocardia farcinica is an emerging pathogen in immunocompromised patients, accounting for approximately 20% of Nocardia clinical isolates in various countries. A case of fatal N. farcinica bacteremia in a 52-year-old man with lung cancer is described. He was admitted with severe respiratory distress, and despite the early onset of empirical antibiotic treatment, he failed to respond and died of septic shock 24 hours later. N. farcinica was isolated from blood cultures obtained at hospital admission and was identified by conventional methods. Strain identification was confirmed by nucleotide sequencing of the 16S rRNA gene. N. farcinica bacteremia is a life-threatening infection. Because of the actinomycete's highly-resistant antibiotic profile, early identification and antibiotic susceptibility testing are necessary to improve the chances of survival.