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Chest Infections: Infections: Fungal |

Special Clinical Manifestations of Nocardia: Two Cases and a Literature Review FREE TO VIEW

Yu Songsong; Wang Jing; Fang Qiuhong
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Beijing Shijitan Hospital, Capital Medical University, Beijing, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A127. doi:10.1016/j.chest.2016.02.132
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SESSION TITLE: Infections: Fungal

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Nocardiosis is a rare bacterial infection of either the lungs (pulmonary) or entire body (systemic) caused by aerobic actinomycetes in Nocardia, a Gram-positive bacteria, that usually affects immunocompromised patients. The most common pulmonary radiological abnormalities are cavity, nodus, mass, or alveolar infiltrate. Most of the lesions of the lung are unilateral.

METHODS: Two middle-aged male patients of Asian descent were studied. The first had a history of fever, weight loss over 3 months, and shortness of breath with exertion. The other presented with dyspnea, cough, and a mass on the right side of the neck that had remained for 1 month. Chest CT of both patients showed a lung mass or suspected tumor; microscopic analysis of respiratory samples suggested an infection with Nocardia spp. The patients’ symptoms improved and the mass lesions resolved with treatment. The clinical manifestations of lung nocardiosis have no specificity. Microscopic and culture findings from tissue samples using a bronchoscope revealed Nocardia wallacei. Multiple high-density sheet shadows in bilateral lungs and nodules or cavitation are the most common presentations, while a huge pulmonary mass is very rare. The finial diagnosis is dependent on bacteriology.

RESULTS: Lung nocardiosis is an opportunistic infection caused by Nocardia. There is no specificity in the clinical manifestation of the disease. The imaging characteristics might be atypical or present as a huge mass in the lung. Isolation and identification of Nocardia strains is the only gold standard for diagnosis.

CONCLUSIONS: Lung nocardiosis is an opportunistic infection caused by Nocardia. There is no specificity in the clinical manifestation of the disease. The imaging characteristics might be atypical or present as a huge mass in the lung. Isolation and identification of Nocardia strains is the only gold standard for diagnosis.

CLINICAL IMPLICATIONS: Lung nocardiosis is an opportunistic infection caused by Nocardia. There is no specificity in the clinical manifestation of the disease. The imaging characteristics might be atypical or present as a huge mass in the lung. Isolation and identification of Nocardia strains is the only gold standard for diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Yu Songsong, Wang Jing, Fang Qiuhong

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