A 28-year-old female belonging to lower socioeconomic class, presented at the outpatient clinic with complaints of shortness of breath and cough with expectoration accompanied by episodes of fever. She had been diagnosed earlier with bilateral bronchiectasis and had left lower lobectomy of the lung performed four years prior to this presentation. She had been hospitalized several times for similar complaints. On detailed elicitation of clinical history, the patient informed that she has had symptoms pertaining to the respiratory tract since the age of two and had been investigated several times for pulmonary tuberculosis but with negative results each time. On examination, she looked ill built and emaciated. Chest auscultation revealed bilateral crepitations. Chest x-ray shows bilateral mid and lower zone consolidation, more on the right side along with compensatory hyperlucency in the left upper zone due to left lower lobe lobectomy (Figure 5). She was hospitalized for management of presumptive pulmonary infection and to evaluate the other causes of fever if any. Patient was started on empirical treatment with intravenous piperacillin/tazobactam 4.5 gm IV TDS. Routine blood workup did not reveal any abnormality, and blood and urine cultures were sterile. Sputum was sent for culture and smear examination with modified acid-fast staining. The smear revealed weakly acid-fast branching filamentous bacilli characteristic of Nocardia. Gram's stain also showed the presence of Gram-positive branching bacilli. The organism grew in culture after 72 hours of incubation. For species identification, 16S rRNA gene sequencing was done, and a BLAST search of the sequence was done using the taxonomy browser of the National Center for Biotechnology Information (NCBI). The 732 bp of the sequence revealed a 99.32% match with Nocardia beijingensis species. The sequence was submitted to GenBank with accession number MK641488. The patient was started on oral cotrimoxazole monotherapy. She improved considerably, and the fever subsided. Dyspnoea improved dramatically. She was discharged after three weeks of therapy with advice to continue oral cotrimoxazole.
 N. beijingensis infections have been described in both immunocompetent and immunosuppressed hosts. Disseminated infection has been described in immunocompetent hosts. Pneumonia, pulmonary abscess, and endobronchial lesions are the other kind of clinical presentations associated with this species. N. beijingensis was first described by Wang et al. from a soil sample in a sewage ditch at Xishan Mountain in Beijing. Strains have been isolated in Asia between 2004 and 2010 from patients with pulmonary nocardiosis and in immunocompromised patients.