Pulmonary norcadosis

Case contributed by Dr Henry Knipe

Presentation

Fatigue, hypotension, hypoxia. Past history CLL.

Patient Data

Age: 63
Gender: Male
Modality: X-ray

Right basal consolidation and pleural effusion with nodules throughout the remainder of the lung.

Modality: CT

Extensive right lower lobe consolidation and small area of left basal consolidation. Ground-glass changes and small pleural effusions bilaterally. 

Numerous new pulmonary nodules throughout both lungs, the largest of which is in the left upper lobe (20 x 18 x 18mm) with possible early cavitation.

No pulmonary embolus identified down to the subsegmental level.

Previous splenectomy. 

Case Discussion

Blood cultures grew Nocardia spp. and this is presumed cause of the pneumonia.

Nocardia most commonly occurs in immunosuppressed patients (as in this case). 

Findings on CT include:

  • pulmonary consolidation (most common)
  • multiple pulmonary nodules of varying size (cavitation may occur)
  • pleural effusion is commonly associated
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Case Information

rID: 34497
Case created: 24th Feb 2015
Last edited: 28th Feb 2016
System: Chest
Inclusion in quiz mode: Included

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