Pulmonary nocardiosis in the acquired immunodeficiency syndrome, computed tomographic findings: a case report

Abstract

The authors describe a case of pulmonary nocardiosis in a 37-year-old man with acquired immunodeficiency syndrome in treatment with antiretroviral drugs. Clinical symptoms were productive cough, hemoptysis and progressive weight loss. A chest x-ray showed a right upper lobe consolidation while the computed tomography demonstrated consolidation with air bronchogram and airspace nodules. The radiologic findings were unspecific. Consequently, a bronchoscopy with bronchoalveolar lavage was performed, revealing filamentous Gram-positive bacteria (Nocardia species). Treatment with trimethoprim-sulfamethoxazole resulted in complete remission of the respiratory symptoms.

Ventilator-dependent pulmonary nocardiosis in a patient with chronic obstructive pulmonary disease

“…Nocardia is aerobic Gram-positive bacteria that can cause opportunistic infections through direct inhalation in the lungs, brain, and skin of immunocompromised individuals. [ 1 2 ] Due to its inherent inoculation pathway, 90% of nocardiosis involves the pulmonary system. [ 1 ] Pulmonary nocardiosis (PN) has been reported to occur mostly in the following populations: HIV patients, lymphoreticular cancer patients, transplant recipients, alcoholics, and diabetics.…”

“…[ 1 2 ] Due to its inherent inoculation pathway, 90% of nocardiosis involves the pulmonary system. [ 1 ] Pulmonary nocardiosis (PN) has been reported to occur mostly in the following populations: HIV patients, lymphoreticular cancer patients, transplant recipients, alcoholics, and diabetics. Disseminated nocardiosis has been reported to even mimic a metastatic malignancy in the immunosuppressed.…”