Pulmonary nocardiosis caused by <i>Nocardia exalbida</i> mimicking lung cancer

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  • Chika Miyaoka
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan
  • Keitaro Nakamoto
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan
  • Tatsuya Shirai
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan
  • Maki Miyamoto
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan
  • Yuka Sasaki
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan
  • Ken Ohta
    Department of Respiratory Medicine, Fukujuji Hospital Japan Anti‐Tuberculosis Association Kiyose Japan

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<jats:p>Nocardiosis is an uncommon infection caused by <jats:italic>Nocardia</jats:italic> species, but it can often occur in immunocompromised patients. As computed tomography (CT) findings of pulmonary nocardiosis, consolidation, masses, and nodules are often found, but lymph node enlargement is infrequent. <jats:italic>Nocardia exalbida</jats:italic> was first isolated in 2006, and there are still few reports on this microorganism. We report a case of pulmonary nocardiosis caused by <jats:italic>N. exalbida</jats:italic> presenting as a mass and lymph node enlargement that mimicked lung cancer. A 76‐year‐old man was referred and admitted to our hospital because of persistent cough, sputum production, and chest discomfort. Chest CT showed a mass in the superior segment of the left upper lobe and mediastinal lymph node enlargement. After we performed bronchoscopies, <jats:italic>Nocardia</jats:italic> species was isolated in a cultured specimen and identified as <jats:italic>N. exalbida</jats:italic>. This case required differentiation from lung cancer and was difficult to diagnose.</jats:p>

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