Blood-borne pulmonary infection with Nocardia asteroides in a heroin addict.

Nocardia asteroides frequently causes primary lung infection with possible hematogenous dissemination to various organs, especially in patients with altered immune responses. The preponderance of pulmonary infections suggests an airborne route of contamination. We report a case of pulmonary nocardiosis in a previously healthy intravenous heroin abuser. The clinical and epidemiologic data strongly suggest a paraphernalia blood-borne infection in this patient, a mode of contamination which has not been previously reported.