CTICasesDisseminated Nocardiosis with Cavitation in a Kidney Transplant Recipient
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Imaging findings
Chest CT in an immunocompromised kidney transplant patient shows extensive, bilateral, random micronodules, widespread areas of consolidation, and a large, thick-walled cavitary lesion in the left upper lobe, representing a rapidly necrotizing infection. Cultures confirmed Nocardia.
Key takeaways
Nocardia is an opportunistic, Gram-positive, weakly acid-fast branched bacterium that primarily affects immunocompromised hosts, such as solid organ transplant recipients. Pulmonary nocardiosis can present with a wide variety of imaging findings, including nodules, consolidation, masses, and abscesses with cavitation. Rapidly progressive or multi-lobar disease can mimic other aggressive necrotizing infections (such as Staphylococcus aureus or Aspergillus) and requires targeted, long-term antibiotic therapy.
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