Presentation
Immunosuppressed patient presenting with chest pain and worsening dyspnoea.
Patient Data
Axial contrast-enhanced CT of the thorax demonstrating ground glass opacity and solid pulmonary nodules with lower lobe predominance. Many of the solid nodules contain cavities. Some of these solid lesions abut the pleura, however no significant pleural thickening is visualised.
Incidentally noted are surgical emphysema and an IV port within the right anterior and lateral chest wall however no pneumothorax or pneumomediastinum. An aberrant right subclavian artery is also noted.
Case Discussion
This is a case of a 55 year old female with past history of SLE and CVID who presented with chest pain and worsening dyspnoea. CT angiography was performed to rule out pulmonary embolism and it demonstrated innumerable ground glass and solid pulmonary nodules with cavitation.
Patient subsequently underwent broncho-alveolar lavage which demonstrated Nocardia. Patient was then started on 12 months of ceftriaxone and linezolid.