Nocardiosis dissemination following transthoracic needle biopsy: two case reports

Infez Med. 2010 Jun;18(2):115-9.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Biopsy, Needle / adverse effects*
  • Biopsy, Needle / methods
  • Female
  • Humans
  • Lung / pathology
  • Male
  • Nocardia / isolation & purification
  • Nocardia Infections / drug therapy
  • Nocardia Infections / etiology
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / microbiology
  • Pleural Effusion / pathology
  • Pneumonia / microbiology
  • Pneumonia / pathology
  • Pseudomonas Infections / microbiology
  • Pseudomonas Infections / pathology
  • Radiography, Interventional
  • Skin / microbiology
  • Solitary Pulmonary Nodule / pathology
  • Thoracic Wall / injuries*
  • Thoracic Wall / microbiology
  • Tomography, X-Ray Computed
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Wound Infection / drug therapy
  • Wound Infection / etiology*
  • Wound Infection / microbiology

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination