Tanaka Takeshi, Kuroki Reiki, Ishida Masayuki, Honda Shoko, Tagawa Tsutomu, Nagayasu Takeshi, Hayashi Tomayoshi, Tsuchihashi Yoshiko, Morimoto Konosuke, Ariyoshi Koya
Department of Infectious Diseases, Nagasaki University Hospital of Medicine and Dentistry.
Nihon Kokyuki Gakkai Zasshi. 2009 Jul;47(7):647-51.
A 51-year-old man with bronchiectasis and persistent lower respiratory tract infection was referred to our hospital for further evaluation of a mass shadow in the upper lung field on his chest X-ray film in February 2006. Two Nocardia spp (N. cyriacigeorgica and N. farcinica) were simultaneously identified from sputum collected through bronchoscopy by culture. We diagnosed pulmonary nocardiosis and commenced minocycline treatment. The possibility of lung cancer was excluded by sputum cytology and CT guided lung biopsy. Remarkable improvement of the mass lesion was recognized after treatment for 6 months. To the best of our knowledge, double infection of two species of Nocardia is very rare.
一名51岁患有支气管扩张症和持续性下呼吸道感染的男性患者,因2006年2月胸部X线片显示上肺野有肿块阴影而被转诊至我院进一步评估。通过支气管镜收集的痰液培养同时鉴定出两种诺卡菌属(乔治亚州诺卡菌和鼻疽诺卡菌)。我们诊断为肺诺卡菌病并开始使用米诺环素治疗。通过痰细胞学检查和CT引导下肺活检排除了肺癌的可能性。治疗6个月后,肿块病变有明显改善。据我们所知,两种诺卡菌的双重感染非常罕见。