A Case of Pulmonary Nocardiosis Diagnosed by Percutaneous Aspiration

• Published in: Nihon Kyōbu Shikkan Gakkai zasshi Vol. 28; no. 4; pp. 651 - 655
• Main Authors: Nakahara, Yasuharu, Nakahara, Yukiko, Ikegami, Yumiko, Ishida, Tadashi, Ushida, Shinichi, Mochizuki, Yoshirou, Matsuyama, Eiichi
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japanese Respiratory Society 01.04.1990
• Subjects: Aged; Anti-Bacterial Agents; Biopsy, Needle - methods; Diagnosis, Differential; Drug Therapy, Combination - therapeutic use; Humans; Lung Diseases, Fungal - diagnosis; Lung Diseases, Fungal - drug therapy; Male; Nocardia Infections - diagnosis; Nocardia Infections - drug therapy; Percutaneous aspiration; Pulmonary nocardiosis; Sulfamethoxazole - therapeutic use; Trimethoprim - therapeutic use
• ISSN: 0301-1542; 1883-471X
• DOI: 10.11389/jjrs1963.28.651

A 71-year-old man complained of mild dyspnea, and his chest X-ray showed a cavitating lesion accompanied by infiltrative changes in the right middle lobe. Percutaneous aspiration revealed numerous gram-positive and acidfast branching rods. Morphological examination and biochemical tests of the colonies confirmed the diagnosis of pulmonary nocardiosis caused by nocardia asteroides. The patient was treated successfully with sulfamethoxazoletrimethoprim. It has been reported that approximately half of the patients with pulmonary nocardiosis have immunodeficiency, but our patient had no underlying disease. This disease has no characteristic clinical features, so diagnosis is difficult. As nocardia may invole the central nervous system leading to a poor prognosis, early diagnosis and prompt treatment are required to improve survival.