Pulmonary nocardiosis: CT findings.
OBJECTIVE
To evaluate CT findings of pulmonary nocardiosis in immunocompromised patients. MATERIALS ALND METHODS: Five patients with bacteriologically confirmed pulmonary nocardiosis were evaluated. Four patients were receiving corticosteroids with or without other immunosuppressive drugs for lupus nephritis (two patients), idiopathic thrombocytopenic purpura (one patient), and renal transplantation (one patient), and one patient had long-standing diabetes. Nocardia asteroides was isolated from blood culture, bronchial washing, pleuropulmonary aspirates, or open lung biopsy. Plain chest radiography and CT were performed on all patients, and follow-up CT was performed on one patient.


RESULTS
On CT there were pleural effusion (four patients), air-space consolidation with internal low attenuation with or without cavities (four patients), multiple noncavitating pulmonary nodules and subpleural pulmonary nodules (three patients), and chest wall extension (three patients). Follow-up CT after treatment showed marked improvement of the pleural and pulmonary lesions.


CONCLUSIONS
In the immunocompromised and chronically debilitated host, pulmonary nocardiosis should be included in differential diagnosis if chest CT shows consolidation with low attenuation areas with or without cavitation, multiple pulmonary nodules, pleural effusion, and chest wall extension.
Yoon
H K
HK
Department of Radiology, Seoul National University Hospital, Korea.
Im
J G
JG
Ahn
J M
JM
Han
M C
MC
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D003920:Diabetes Mellitus / Q000276:immunology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000276:immunology / Q000382:microbiology*; D008297:Male; D009617:Nocardia Infections / Q000000981:diagnostic imaging* / Q000276:immunology; D009616:Nocardia asteroides; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents