CTICasesPulmonary Nocardia nova Infection in an Immunocompetent Host
Imaging findings
CT demonstrates a miliary-like pattern of small randomly distributed pulmonary nodules with some perilymphatic distribution along fissures and relative basal sparing, in an immunocompetent patient presenting with fever and cough following heavy compost exposure.
Key takeaways
Nocardia nova is a soil-dwelling filamentous bacterium related to Actinomyces that can cause pulmonary infection even in immunocompetent individuals following high-inoculum environmental exposure (e.g., composting, soil work). It is distinct from most other nocardia infections, which require a predisposing immunodeficiency. CT findings can mimic miliary fungal disease or mycobacteria.
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