# Nocardia Infection Complicated by Severe Hyponatremia in a Renal Transplant Patient

## TL;DR

A kidney transplant patient developed a rare Nocardia infection and severe low sodium levels, highlighting an unusual complication in immunosuppressed individuals.

## Contribution

This case highlights the rare association of pulmonary nocardiosis with severe hyponatremia in renal transplant recipients.

## Key findings

- Pulmonary nocardiosis can present with severe hyponatremia in renal transplant patients.
- Nocardiosis is uncommon but serious in immunocompromised individuals if not treated promptly.
- Electrolyte disturbances are rarely reported with nocardiosis.

## Abstract

Patients with solid organ transplants are at high risk for opportunistic infections due to the use of potent immunosuppressive drugs. Nocardiosis is a Gram-positive, aerobic actinomycete infection that is uncommon but can be serious in solid organ transplant recipients if not treated promptly. It often presents pulmonary or disseminated disease. Nocardia can infect immunocompromised patients mainly by airborne transmission. We recently encountered a challenging case of pulmonary nocardiosis with severe hyponatremia in a renal transplant recipient. We chose to write this case to highlight the association of pulmonary nocardiosis with severe hyponatremia in a renal transplant recipient, as nocardiosis rarely presents with profound electrolyte disturbances.