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Lobar Pneumonia due to Nocardia

Imaging findings

Chest radiograph and subsequent chest CT demonstrate a focal, dense area of lobar consolidation with air bronchograms in the right upper lobe, nicely marginating the minor fissure. There is also mild ground-glass opacity in the right middle lobe.

Key takeaways

Pulmonary nocardiosis typically presents as opportunistic multifocal nodules or mass-like consolidation in immunocompromised patients, such as kidney transplant recipients. It can rarely present as simple lobar pneumonia mimicking common bacterial pathogens. Because Nocardia is not part of normal human flora, any isolation from clinical specimens should be considered clinically significant rather than a contaminant.

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