title: Nocardiosis dissemination following transthoracic needle biopsy: two case reports.
abstract: Pulmonary nocardiosis is a rare respiratory infection whose diagnosis can easily be missed because there are no suggestive symptoms. Nocardiosis is typically regarded as an opportunistic infection, but one-third of infected patients are immunocompetent. We present two situations of pulmonary lesions in immunocompetent people. A CT-guided percutaneous transthoracic needle biopsy was performed in both cases but was not informative. Suppurative inflammation had developed as a complication of the procedure in the biopsy site after 1-2 weeks. Pus was aspirated and culture showed Nocardia spp. Therefore we hypothesize that the pulmonary lesion was caused initially by Nocardia which had subsequently disseminated to the chest wall after the biopsy. Treatment with trimethoprim/sulfamethoxazole was undertaken. Resolution of the disease was evaluated according to the clinical symptoms and radiological resolution after 6 months therapy.
authors.affiliation: Department of Histology, Microbiology, and Medical Biotechnology, University of Padua, Padua Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Forner
authors.forename: Carlo
authors.initials: C
authors.lastname: Mengoli
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Fuser
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Scotton
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D011014:Pneumonia / Q000382:microbiology / Q000473:pathology; D011552:Pseudomonas Infections / Q000382:microbiology / Q000473:pathology; D015641:Radiography, Interventional; D012867:Skin / Q000382:microbiology; D003074:Solitary Pulmonary Nodule / Q000473:pathology; D035441:Thoracic Wall / Q000293:injuries* / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014946:Wound Infection / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination