title: Pulmonary nocardiosis with bilateral diffuse granular lung shadows in a patient with subcutaneous panniculitic T-cell lymphoma.
abstract: A 40-year-old woman undergoing prednisolone and cyclosporine therapy for subcutaneous panniculitic T-cell lymphoma complained of a cough for a few weeks. A chest X-ray revealed bilateral diffuse granular shadows. Additionally, the patient was discovered to have multiple subcutaneous abscesses. Gram-stained smears of sputum and pus from the abscess showing branched gram-positive rods led to a diagnosis of pulmonary nocardiosis with dissemination to the lungs and subcutaneous tissues. Combination therapy consisting of sulfamethoxazole/trimethoprim and panipenem/betamipron produced rapid improvement of radiographic abnormalities. It is suggested that pulmonary nocardiosis should be considered in the differential diagnosis of diffuse granular shadows on chest X-rays, especially in immunocompromised patients.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Jichi Medical School, Minamikawachi, Tochigi.
authors.forename: Munehiro
authors.initials: M
authors.lastname: Enomoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamasawa
authors.forename: Toyomitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Masashi
authors.initials: M
authors.lastname: Bando
authors.forename: Shoji
authors.initials: S
authors.lastname: Ohno
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D016410:Lymphoma, T-Cell, Cutaneous / Q000150:complications*; D009617:Nocardia Infections / Q000150:complications* / Q000000981:diagnostic imaging; D015434:Panniculitis / Q000382:microbiology*; D011859:Radiography; D012878:Skin Neoplasms / Q000150:complications*