Pulmonary infection by Nocardia spp. has been recognized the last decades. Nocardia is an opportunistic pathogen in immunocompromised individuals; nevertheless, it has been recognized as an uncommon pathogen in immunocompetent patients. We report a case of pulmonary infection by Nocardia asteroides in an immunocompetent host who had a history of sulfate acid aspiration, followed by gastric tube interposition, reconstruction of the hypopharynx and gastric-hypopharyngial anastomosis.