Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients
Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs we...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2020/8840920 |
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| author | Samshol Sukahri Lily Diana Zainudin Mohd Firdaus Hadi Mohd Al-Baqlish Mohd Firdaus Muhammad Imran Abdul Hafidz |
| author_facet | Samshol Sukahri Lily Diana Zainudin Mohd Firdaus Hadi Mohd Al-Baqlish Mohd Firdaus Muhammad Imran Abdul Hafidz |
| author_sort | Samshol Sukahri |
| collection | DOAJ |
| description | Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy. |
| format | Article |
| id | doaj-art-474c8e8eec7740debaf91bc870ae9fbd |
| institution | DOAJ |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-474c8e8eec7740debaf91bc870ae9fbd2025-08-20T02:39:19ZengWileyCase Reports in Pulmonology2090-68462090-68542020-01-01202010.1155/2020/88409208840920Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent PatientsSamshol Sukahri0Lily Diana Zainudin1Mohd Firdaus Hadi2Mohd Al-Baqlish Mohd Firdaus3Muhammad Imran Abdul Hafidz4General Medical Unit, Department of Medicine, University Technology MARA, MalaysiaGeneral Medical Unit, Department of Medicine, University Technology MARA, MalaysiaDivision of Cardiology, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, MalaysiaDivision of Cardiology, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, MalaysiaDivision of Cardiology, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, MalaysiaPulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.http://dx.doi.org/10.1155/2020/8840920 |
| spellingShingle | Samshol Sukahri Lily Diana Zainudin Mohd Firdaus Hadi Mohd Al-Baqlish Mohd Firdaus Muhammad Imran Abdul Hafidz Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients Case Reports in Pulmonology |
| title | Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients |
| title_full | Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients |
| title_fullStr | Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients |
| title_full_unstemmed | Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients |
| title_short | Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients |
| title_sort | recurrent empyema thoracic secondary to pulmonary nocardiosis in immunocompetent patients |
| url | http://dx.doi.org/10.1155/2020/8840920 |
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