title: Successful treatment of pulmonary nocardiosis with fluoroquinolone in bronchial asthma and bronchiectasis.
abstract: A 72-year-old Japanese woman was admitted at Saga University Hospital for fever, malaise, and productive cough. Six years ago, she had been diagnosed with bronchial asthma and was treated with inhaled corticosteroids. Chest radiograph and computed tomography on admission showed infiltrates in the right middle lobe, a mass lesion in the left lower lobe, and bronchiectasis in both lower lobes. Sputum examination showed Gram-positive rods with phagocytosis by neutrophils. These bacilli were identified as Nocardia otitidiscaviarum by 16S ribosomal RNA sequencing. Therefore, she was diagnosed with pulmonary nocardiosis and was treated with trimethoprim/sulfamethoxazole (TMP-SMX) and minocycline (MINO). However, she had to discontinue these antibiotics because of severe nausea and anorexia and instead was treated with fluoroquinolone for 6 months. There was resolution of the disease thereafter. Pulmonary nocardiosis with bronchial asthma and bronchiectasis can be successfully treated with fluoroquinolone, an alternative to TMP-SMX or MINO.
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Sadamatsu
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Koichiro
authors.identifier: 0000-0003-0461-5072
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tashiro
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Komiya
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sueoka-Aragane
keywords: Bronchial asthma; fluoroquinolone; inhaled corticosteroid; pulmonary nocardiosis