Department of Respiratory Medicine, Kumamoto Chuo Hospital, Tainoshima, Minami-ku, Kumamoto, Japan.
Department of Respiratory Medicine, Kumamoto Chuo Hospital, Tainoshima, Minami-ku, Kumamoto, Japan.
Chest. 2024 Jan;165(1):e1-e4. doi: 10.1016/j.chest.2023.07.067.
We report a rare case of pulmonary nocardiosis with endobronchial involvement caused by Nocardia araoensis. A 79-year-old man with a history of asthma and a previous right upper lobectomy for lung cancer and organizing pneumonia presented with cough and dyspnea. He presented with right bronchial stenosis associated with various mucosal lesions, including ulcerative and exophytic lesions. N araoensis was detected in sputum samples collected via bronchoscopy. The mucosal lesions improved after a 2-week course of meropenem. After a further 6 months of oral sulfamethoxazole-trimethoprim treatment, the mucosal lesions completely disappeared. Based on bronchoscopic and pathophysiologic findings, the patient was diagnosed with pulmonary nocardiosis with endobronchial involvement. Nocardiosis should be considered in the differential diagnosis of endobronchial mucosal lesions.
我们报告了一例由嗜气道诺卡菌引起的罕见支气管内受累型肺部诺卡菌病。一名 79 岁男性,有哮喘病史,曾因肺癌和机化性肺炎行右上肺叶切除术,因咳嗽和呼吸困难就诊。他表现为右支气管狭窄,伴有各种黏膜病变,包括溃疡性和外生性病变。通过支气管镜采集的痰样本中检测到嗜气道诺卡菌。黏膜病变在接受美罗培南治疗 2 周后得到改善。经过 6 个月的口服磺胺甲噁唑-甲氧苄啶治疗后,黏膜病变完全消失。根据支气管镜和病理生理发现,该患者被诊断为支气管内受累型肺部诺卡菌病。在鉴别诊断支气管内黏膜病变时应考虑诺卡菌病。