Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients

Overview

Journal Pol J Radiol

Publisher Termedia

Specialty Radiology

Date 2015 Jan 14

PMID 25584096

Citations 7

Authors

Payam Mehrian

Ehsan Esfandiari

Mohammad Ali Karimi

Behzad Memari

Affiliations

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Abstract

Background: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients.

Material/methods: CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1).

Results: Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups.

Conclusions: Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition.

Citing Articles

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Nocardiosis in patients with nephrotic syndrome: a retrospective analysis of 11 cases and a literature review.

Guo J, Li S, Xu S, Jiang L, Gao E, Liu Z Int Urol Nephrol. 2020; 52(4):731-738.

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Pulmonary Nocardiosis: A Clinical Analysis of 30 Cases.

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