Pulmonary nocardiosis: a 7-case report and literature review

Abstract

Objective To analyze the clinical features,characteristics of imaging and laboratory examination of pulmonary nocardiosis.Methods The clinical data of 7 patients with pulmonary nocardiosis admitted to the First Affiliated Hospital of Guangzhou Medical University from January 2012 to April 2014 were retrospectively analyzed,including medical history,symptoms and signs,imaging and laboratory data,etiologic features and management.Results Of 7 patients,2 were otherwise healthy,and 5 were with underlying diseases.Two patients had been treated with immunosuppressants or glucocorticoids.The clinical manifestations included cough (n=7),expectoration (n=7),fever (n=4),dyspnea (n=3),chest pain (n=1),hemoptysis (n=1) and emaciation (n=1).Pulmonary high-resolution CT scan revealed single or multiple nodular shadows (n=3),infiltrates (n=3),lung masses (n=l),complicated with cavity formation (n=3),mediastinal lymphadenectasis (n=2),and pleural effusion (n=3).Among 7 patients with pulmonary nocardiosis,there were 3 strains of Nocardia brasiliensis,1 of Nocardia asteroids,and other 3 of nonclassified Nocardia.Sulfonamides were effective for most patients.Conclusions Most patients with pulmonary nocardiosis may have underlying diseases with nonspecific clinical manifestations.Single or multiple pulmonary nodules and infiltrates are the most common presentation in imaging studies.Sulfonamides are effective for most of the patients. Key words: Pulmonary nocardiosis ; Bacterial infections ; Tomography, X-ray computed