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.

中文翻译：

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布鲁氏菌感染合并诺卡氏菌感染一例报告并文献复习

人类布鲁氏菌病是由布鲁氏菌引起的传染病，经常因不明原因发烧、头痛、虚弱等不典型表现而被误诊。诺卡氏菌病是由诺卡氏菌属引起的人畜共患疾病，通常通过呼吸道、皮肤和消化道传播。有限的研究记录了患者同时感染布鲁氏菌和诺卡氏菌病原体的病例。一名55岁男性因间歇性高烧入院。经过痰液和血培养以及其他实验室检查，患者被诊断患有布鲁氏菌病和诺卡氏菌病。根据既往研究和报道建议，患者先后接受左氧氟沙星、强力霉素、哌拉西林钠舒巴坦钠、甲氧苄氨嘧啶磺胺甲恶唑、利福平、替加环素治疗，随后患者康复出院。布鲁氏菌和诺卡氏菌都是机会致病菌，布鲁氏菌和诺卡氏菌同时感染的情况比较少见。如果患者在接受经验性抗生素治疗后仍持续发烧，则有必要进行检查以识别潜在的非典型病原体，包括布鲁氏菌和诺卡氏菌。痰染色、痰培养、血培养是临床中重要的辅助检查。应根据指南和患者个体情况选择治疗计划。应定期进行重新评估，并相应调整抗菌药物。