Pulmonary nocardiosis with bilateral diffuse granular lung shadows in a patient with subcutaneous panniculitic T-cell lymphoma.
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.
Enomoto
Munehiro
M
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical School, Minamikawachi, Tochigi.
Yamasawa
Hideaki
H
Sawai
Toyomitsu
T
Bando
Masashi
M
Ohno
Shoji
S
Sugiyama
Yukihiko
Y
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*