Endobronchial pulmonary nocardiosis.

In recent years, the reported incidence of nocardiosis, a localized or disseminated infection caused by Nocardia, has been increasing. This increase can be attributed to the improvements in diagnostic capabilities and the higher clinical index of suspicion, as well as the increased prevalence of immunosuppressed patients. We report a case of pulmonary nocardiosis in a healthy young female who presented with cough and hemoptysis, which persisted even after empiric treatment for pulmonary tuberculosis. CT scan of her chest showed infiltrates in the right upper, middle and lower lobes with pleural effusion. Bronchoscopy revealed a friable endobronchial mass. Special stains confirmed the diagnosis of nocardiosis. The patient's symptoms and clinical findings improved with trimethoprim-sulfamethoxazole. To the best of our knowledge, this is the fourth case of this illness presenting as endobronchial mass reported in the literature. Pulmonary nocardiosis should be considered in the differential diagnosis of hemoptysis, even in immunocompetent patients.