Department of Clinical and Molecular Medicine, Sapienza University, Pneumology UOC, Sant'Andrea Hospital, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2011 Apr;15(4):401-5.
It is reported the case of a subject 54 years old, painter, drinker and smoker who after an episode of cooling and the occurrence of widespread pain was taking its own initiative, cortisone and analgesics from approximately 30 days. The symptoms worsened and the patient was hospitalized. Chest X-ray and CT scan showed an extensive opacity in the left upper lobe with excavations in the context and also some nodular opacities excavated in the contralateral lung. In the first eight days after admission, the clinical picture despite empirical antibiotic therapy worsened towards adult respiratory distress syndrome (ARDS). On the ninth day after the admission, strains of Nocardia farcinica and Staphylococcus haemoliticus were isolated from the sputum. The targeted therapy (trimethoprim-sulfamethoxazole, amikacin, etc.) induced a rapid improvement of the clinical picture that was resolved in 6 months. Pneumonia caused by Nocardia farcinica is rare but its identification is necessary to set an appropriate therapy.
据报道，该病例为一名 54 岁男性，画家，有饮酒和吸烟史。在一次受凉后出现全身疼痛，他自行服用了约 30 天的可的松和止痛药。症状恶化后，患者住院治疗。胸部 X 光和 CT 扫描显示左肺上叶广泛不透明，伴有空洞形成，对侧肺部也有一些结节状不透明。入院后 8 天内，尽管进行了经验性抗生素治疗，患者的临床症状仍逐渐恶化，发展为成人呼吸窘迫综合征（ARDS）。入院第 9 天，从痰中分离出诺卡氏菌和溶血性葡萄球菌。针对性治疗（甲氧苄啶-磺胺甲恶唑、阿米卡星等）迅速改善了临床症状，6 个月后痊愈。诺卡氏菌引起的肺炎较为罕见，但为了制定适当的治疗方案，明确其诊断是必要的。
