J A Buckley1, A R Padhani, J E Kuhlman. 1. Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Abstract
OBJECTIVE: Our goal was to identify the CT features of pulmonary nocardiosis, specifically in AIDS patients versus other immunocompromised hosts. MATERIALS AND METHODS: Twenty-four patients with pulmonary nocardiosis were identified; medical records, CT scans, and chest radiographs were reviewed. Five patients had HIV disease, 17 had other causes of immunosuppression, and 2 had normal immunity. RESULTS: CT features of pulmonary nocardiosis included one or more nodules/masses (20/24 cases, 83%), cavitation (8, 33%), consolidation/infiltrates (8, 33%), and pleural thickening (7, 29%). All AIDS patients with nocardiosis had multiple (four or more) nodules detected on CT and 80% (4/5) had cavitation compared with 21% each of non-AIDS patients (p < 0.01 for multiple nodules, p < 0.045 for cavitation). CONCLUSION: CT features of pulmonary nocardiosis are varied, and AIDS patients are more likely to display cavitation and multiple nodules. Although not widely recognized, Nocardia infection should be included in the differential diagnosis of an unexplained nodule or progressive cavitary process in HIV-positive patients.
OBJECTIVE: Our goal was to identify the CT features of pulmonary nocardiosis, specifically in AIDSpatients versus other immunocompromised hosts. MATERIALS AND METHODS: Twenty-four patients with pulmonary nocardiosis were identified; medical records, CT scans, and chest radiographs were reviewed. Five patients had HIV disease, 17 had other causes of immunosuppression, and 2 had normal immunity. RESULTS: CT features of pulmonary nocardiosis included one or more nodules/masses (20/24 cases, 83%), cavitation (8, 33%), consolidation/infiltrates (8, 33%), and pleural thickening (7, 29%). All AIDSpatients with nocardiosis had multiple (four or more) nodules detected on CT and 80% (4/5) had cavitation compared with 21% each of non-AIDSpatients (p < 0.01 for multiple nodules, p < 0.045 for cavitation). CONCLUSION: CT features of pulmonary nocardiosis are varied, and AIDSpatients are more likely to display cavitation and multiple nodules. Although not widely recognized, Nocardia infection should be included in the differential diagnosis of an unexplained nodule or progressive cavitary process in HIV-positivepatients.
Authors: Samshol Sukahri; Lily Diana Zainudin; Mohd Firdaus Hadi; Mohd Al-Baqlish Mohd Firdaus; Muhammad Imran Abdul Hafidz Journal: Case Rep Pulmonol Date: 2020-10-26