NOCARDIOSIS - A RARE CAUSE OF PLEUROPULMONARY DISEASE IN THE IMMUNOCOMPROMISED HOST

We report a case of acute pleuropulmonary nocardial infection in a 24- year-old woman suffering from systemic lupus erythematosus. In most in stances, Nocardia asteroides is an opportunistic pathogen. In our pati ent, the infection was facilitated by systemic lupus erythematosus and chronic use of corticosteroids and immunosuppressive drugs. N. astero ides was cultured from both pleural effusion and blood. No extrathorac ic location was found and the patient improved upon intravenous antibi otics and pleural drainage. Owing to the poor tolerance of trimethopri m/sulfamethoxazole, the patient was treated successfully with imipenem . The predisposing factors, the clues to the diagnosis and the therapy of nocardiosis are briefly reviewed.