Skip Navigation LinksHome > May 2012 - Volume 20 - Issue 3 > An Unusual Presentation of Pulmonary Nocardiosis
Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e318234c4c1
Case Reports

An Unusual Presentation of Pulmonary Nocardiosis

Campos-Santiago, Zulmari MD*; Jimenez-Encarnacion, Esther MD; Vazquez-Sanabria, Irma L. MD; Rodríguez-Cintrón, William MD, FACP, FCCM

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Abstract

Abstract: Nocardia is an ubiquitous microorganism found in soil, organic matter, and water. It is particularly common in immunocompromised patients. A 51-year-old man, nonsmoker with medical history of hypertension and chronic alcoholism, presented with a 2-week history of a right upper quadrant pain, right-side chest pain, general malaise, fatigue, anorexia, 20-lb weight loss, night sweats, unquantified fever, and visual/auditory hallucinations. An abdominal and chest computed tomography reported a right pleura–based mass that eroded into the chest wall. The patient was admitted with diagnosis of suspected primary lung malignancy with a postobstructive pneumonic infection. Intravenous antibiotic was started with vancomycin and piperacillin/tazobactam. Computed tomography–guided needle biopsy was done and pathology reported a gram-positive filamentous branching bacteria, weakly acid-fast positive, consistent with a Nocardia infection. Trimethoprim/sulfamethoxazole therapy, together with pleural effusion management, ensured further resolution of this invasive pleuropulmonary infection.

© 2012 Lippincott Williams & Wilkins, Inc.

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