Nocardiosis of the lung: chest radiographic findings in 21 cases.

Abstract

Pulmonary manifestations of nocardial infection were present in 21 patients, with microbiologic proof in all and pathologic proof in 12. An analysis of the findings in these patients, combined with a review of previous reports of nocardiosis, suggests several important conclusions for radiologists. First, nocardiosis may occur in otherwise healthy persons but is most common in compromised patients, especially those being treated with anti-inflammatory agents, particularly corticosteroids, for chronic obstructive pulmonary disease and other systemic diseases. As pathologic manifestations are both suppurative and granulomatous, the chest radiographic manifestations are pleomorphic and not specific. Consolidations and large irregular nodules, often cavitary, are most common; nodules, masses, and interstitial patterns also occur. Pleural effusions are quite common, and lymph nodes may be enlarged. Difficulty and slowness of culture growth, along with the lack of a serologic test for nocardiosis, necessitate its inclusion in the differential diagnosis for both compromised and noncompromised patients in whom an apparent pulmonary infection cannot be rapidly diagnosed.

The medically important aerobic actinomycetes: epidemiology and microbiology

“…In one case series, one or more areas of cavitation were found on chest radiographs for 42% of patients with pulmonary and disseminated nocardioses, although the authors did not suggest that this finding might be a characteristic pattern of lung involvement for the disease (186). The occurrence of cavitary pneumonia, particularly in a patient with compromised immunity, should alert the clinician to the possibility of nocardial infection (162). In particular, in immunocompromised patients, follow-up chest radiographic examinations may be important because there may often be a marked and rapid progression in radiographic findings.…”

Unexplained Pleural Infection in an Immunosuppressive Patient: Nocardiosis

“…Klinik örneklerin Gram boyası ile boyanması nocardiozisin erken teşhisinde faydalıdır. Hastaların sadece üçte birinde smear ve kültür pozitifliği birliktedir (1,5). Hızlı ve doğru sonuçlanan güncel moleküler teknikler yaygın kullanılmamakla birlikte artık teşhis süre-cinde büyük avantaj sağlamışlardır (7).…”

Neumonías en el inmunocomprometido: perspectiva desde el diagnóstico por imágenes, e inferencia Bayesiana

“…Las neumonías por Nocardia spp (Figura 5) se manifiestan como consolidaciones (52%), nódulos grandes o masas (24%), cavitaciones (62%), efusión pleural (33%), con predominio en los lóbulos superiores (71%) y con patrón intersticial en forma ocasional 42,43 .…”