CT features of pulmonary nocardiosis.
OBJECTIVE
Our goal was to identify the CT features of pulmonary nocardiosis, specifically in AIDS patients versus other immunocompromised hosts.


METHODS
Twenty-four patients with pulmonary nocardiosis were identified; medical records, CT scans, and chest radiographs were reviewed. Five patients had HIV disease, 17 had other causes of immunosuppression, and 2 had normal immunity.


RESULTS
CT features of pulmonary nocardiosis included one or more nodules/masses (20/24 cases, 83%), cavitation (8, 33%), consolidation/infiltrates (8, 33%), and pleural thickening (7, 29%). All AIDS patients with nocardiosis had multiple (four or more) nodules detected on CT and 80% (4/5) had cavitation compared with 21% each of non-AIDS patients (p < 0.01 for multiple nodules, p < 0.045 for cavitation).


CONCLUSIONS
CT features of pulmonary nocardiosis are varied, and AIDS patients are more likely to display cavitation and multiple nodules. Although not widely recognized, Nocardia infection should be included in the differential diagnosis of an unexplained nodule or progressive cavitary process in HIV-positive patients.
Buckley
J A
JA
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Padhani
A R
AR
Kuhlman
J E
JE
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000382:microbiology; D014057:Tomography, X-Ray Computed