Tuberc Respir Dis > Volume 39(4); 1992 > Article
Tuberculosis and Respiratory Diseases 1992;39(4):355-360.
DOI:    Published online August 1, 1992.
A case of nocardiosis.
Jeong Hee Kim1, Ki Heon Yoon1, Jee Hong Yoo1, Hong Mo Kang1, Jin Tae Suh2
1Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Clinical Pathology, College of Medicine, Kyung Hee University, Seoul, Korea
Nocardiosis is an acute, subacute or chronic infection, which usually introduced through the respiratory tract resulting pneumonia, and may develop a disseminated infection, especially subcutaneous abscess and/ or CNS infection. It usually affects the immunocompromised host and may be fatal unless early diagnosis and adequate treatment are performed. There have been only several case reports of nocardial infection in Korea. N ocardiosis is so unfamiliar to many physicians that may be misdiagnosed as pneumonia, tuberculosis, or neoplasm. We have experienced a case of nocardiosis from a patient who had been treated as pneumonia and tuberculosis at first. The 57-year-old male patient had fever, chill, dyspnea and blood tinged purulent sputum for 20 days. Under the impression of bacterial pneumonia, broad spectrum antibiotics were administered for more than 3 weeks without clinical improvement. Although antituberculous drugs began to be administered after acid fast bacilli were found in bronchial aspirate by bronchoscopy, the nocardial infection was suspected due to no clinical response toward antituberculous therapy and the occurrence of multiple subcutaneous abscesses on scalp. The diagnosis was made by modified Ziehl-Neelson stain and culture of the sputum and pus. Nocardia asleroides was identified After 25 days of trimethoprim-sulfamethoxazole treatment, the patient was much improved and discharged
Key Words: Nocardiosis, nocardia asleroides

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