Imaging Findings of Pulmonary Nocardiosis Mimicking Bronchiectasis

J Coll Physicians Surg Pak. 2019 Mar;29(3):278-280. doi: 10.29271/jcpsp.2019.03.278.

Abstract

Nocardia species usually cause opportunistic infections, and the frequency of these infections is increasing owing to the growing population of immunocompromised hosts. However, Nocardia may sometimes causes an infectious disease in immunocompetent hosts. Herein, we report two cases of pulmonary nocardiasis in immunocompetent individuals, whose chest computed tomography (CT) findings mimicked bronchiectasis. Samples of bronchalveolar lavage (BAL) fluid obtained by bronchoscopy showed filamentous, branching, gram-positive rods, acid-fast filamentous branching rods, and a colony of suspected Nocardia was cultured. Based on 16sRNA and hsp65 gene sequence analysis, case 1 was identified as N. cyriacigeorgica, but case 2 was not matched. The patients responded well to treatment with the combination of sulfamethoxazole and linezolid.

MeSH terms

  • Bronchiectasis / diagnosis
  • Bronchiectasis / diagnostic imaging*
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Immunocompetence / immunology
  • Linezolid / therapeutic use*
  • Male
  • Middle Aged
  • Nocardia / drug effects
  • Nocardia / isolation & purification
  • Nocardia Infections / diagnosis
  • Nocardia Infections / diagnostic imaging*
  • Nocardia Infections / drug therapy*
  • Risk Assessment
  • Severity of Illness Index
  • Sulfamethoxazole / administration & dosage*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome

Substances

  • Linezolid
  • Sulfamethoxazole