Nocardiosis with suspected multiple metastases of lung cancer: a case report

Abstract

Abstract Background Nocardiosis is a rare opportunistic infection susceptible to immunocompromised patients. The condition frequently manifests as pulmonary infection and may have imaging characteristics which resemble to lung cancer, such as the nodules and the lymph nodes enlargement, leading to confusion in diagnosis. In addition, Nocardia can also spread through the blood, causing cutaneous and cerebral infections. Case presentation: We report a female patient with long-term oral methylprednisolone and ciclosporin, who had uncommon multiple systemic infections. CT scan showed the patient may be lung cancer with intrapulmonary, subcutaneous and musculature metastases, while the cranial enhanced MRI scan showed brain metastases. Finally, Nocardia was cultured through subcutaneous puncture fluid. After treatment, her multiple organ lesions became significantly smaller or subsided. Conclusions Doctors should consider nocardiosis as a potential infectious disease in patients with compromised immune systems to prevent incorrect diagnosis and treatment.