CT findings of pulmonary nocardiosis: a report of 9 cases.

BACKGROUND

Pulmonary nocardiosis often occurs among immunocompromised patients, especially in those with impaired cell immunity related to AIDS and transplant. As the number of patients receiving transplant, the occurrence of pulmonary nocardiosis may also increase. Radiologic characteristics of this entity have not been well documented. In present study, CT findings of clinical confirmed pulmonary nocardiosis were retrospectively reviewed in order to understand CT features of pulmonary nocardiosis.

METHODS

Electronic databases of Shenzhen People's Hospital, Shenzhen, China, and the Third People's Hospital of Longgang District, Shenzhen, China were searched for patients with definitive diagnosis of pulmonary nocardiosis and available CT images. Nine patients were founded and they were included in this retrospective analysis. Clinical presentations at diagnosis and related medical history were recorded. CT images were retrospectively reviewed by two radiologists in consensus.

RESULTS

The patients consisted of seven men and two women with a median age of 47 years (range, 20-73 years). There were three immunocompromised patients and six immunocompetent patients. The latter included two patients had history of bronchiectasis. The symptoms at the diagnosis were nonspecific of fever, cough, sputum, dyspnea, chest pain, and hemoptysis. CT findings included: lung consolidation (n=8) with cavitation in three cases and foci of decreased enhancement in one patient who had contrast-enhanced CT, nodules/masses (n=6) with cavitation in two patients, ground-glass opacity (n=4), centrilobular nodules (n=4), pleural effusion (n=4), bronchiectasis (n=4), interlobular septal thickening (n=3), interlobular reticular opacity (n=3), lymph node enlargement (n=2), halo sign (n=2) and mucoid impaction (n=1).

CONCLUSIONS

Lung consolidation and nodules/masses are the most common findings, but CT findings of pulmonary nocardiosis are diverse and nonspecific. In some clinical background, such as immunocompromised patients or with some underlying lung diseases, consolidation or nodules/masses with cavitation may suggest the possibility of pulmonary nocardiosis.