High-resolution Computed Tomography Findings in Patients with Pulmonary Nocardiosis

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• 作者：Haruka Sato ; MD^a ; Fumito Okada ; MD^a ; ^{fumitook@oita-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Takaaki Mori ; MD^a ; Asami Ono ; MD^a ; Tomoko Nakayama ; MD^a ; Yumiko Ando ; MD^b ; Akira Matsumoto ; MD^a ; Shuichi Tanoue ; MD^a ; Kazufumi Hiramatsu ; MD^c ; Takehiko Shigenaga ; MD^d ; Masahiro Hata ; MD^d ; Kenji Kishi ; MD^e ; Hiromu Mori ; MD^a
• 关键词：High-resolution computed tomography ; chest ; pulmonary nocardiosis ; community-acquired infection ; nosocomial infection
• 刊名：Academic Radiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：23
• 期：3
• 页码：290-296
• 全文大小：1187 K

文摘

Nocardiosis is difficult to diagnose, and the diagnosis is thus frequently delayed. High-resolution computed tomography (HRCT) findings of patients with pulmonary nocardiosis have been documented in few reports. Our study objective was to assess HRCT findings of patients with pulmonary nocardiosis.

Materials and Methods

This was a retrospective study of 20 consecutive patients with pulmonary Nocardia infections who underwent HRCT of the chest at our institutions from January 2011 to August 2014. After the exclusion of two patients with concurrent infections, the study group comprised 18 patients (11 men, 7 women; age range, 39–83 years; mean, 67.9 years) with pulmonary Nocardia infections. Parenchymal abnormalities, enlarged lymph nodes, and pleural effusion were evaluated on HRCT.

Results

Underlying conditions included respiratory disease (n = 6, 33.3%), collagen diseases (n = 5, 27.8%), and diabetes mellitus (n = 4, 22.2%). All patients showed abnormal HRCT findings, including the presence of a nodule/mass (n = 17, 94.4%), ground-glass opacity (n = 14, 77.8%), interlobular septal thickening (n = 14, 77.8%), and cavitation (n = 12, 66.7%). Pleural effusion was seen in two patients. There were no cases of lymph node enlargement.

Conclusions

Among the HRCT findings in patients with pneumonia, a nodule/mass with interlobular septal thickening and/or cavitation are suggestive of pulmonary nocardiosis.