A 79-year-old-man with SARS-CoV-2 pneumonia and unusual pulmonary co-infection

Patients with severe COVID-19 are characterized by local and systemic inflammatory responses, which are responsible for severe acute respiratory failure. Systemic corticosteroids have been used to counteract the inflammatory cascade in severe respiratory patients. The beneficial effect of corticosteroids may be counteracted by adverse effects, including delayed viral clearance and increased risk of secondary infection. In this regard, we describe a case of a 79-year-old man admitted to the Emergency Department of the Palermo Hospital (Italy) because of respiratory failure and pneumonia caused by SARS-CoV-2 infection who developed Nocardia otitidiscaviarum infection. This case highlights the need to consider coinfections in SARS-CoV-2 patients under high dose of steroids.