CTICasesPulmonary Nocardia wallisia Infection
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Imaging findings
Initial radiograph was unremarkable. Subsequent radiograph showed new nodules. CT demonstrated cavitary nodules in the periphery of the lung, smaller satellite nodules, endobronchial debris, and tree-in-bud opacities. Culture of the infected material grew Nocardia wallisia.
Key takeaways
Nocardia species can cause various pulmonary manifestations, including masses, cavitary nodules, and airways disease such as tree-in-bud opacities, particularly in immunocompromised patients (e.g., post-stem cell transplant). While less common now due to prophylaxis against Pneumocystis jirovecii (PJP) with sulfamethoxazole/trimethoprim, which also covers Nocardia, it remains an important consideration.
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