Pulmonary nocardiosis associated with idiopathic thrombocytopenic purpura

A 69-year-old woman with idiopathic thrombocytopenic purpura, who was regul arly followed and treated with prednisolone and danazol, was admitted to ou r hospital because of shortness of breath. Chest roentgenogram showed a lar ge amount of left-sided pleural effusion. Gram-positive branching rods, sub sequently identified as Nocardia farcinica, were isolated from the fluid. A ntibiotic treatment together with pleural drainage with an intercostal cath eter resulted in complete remission of pyothorax. Pulmonary nocardiosis is a rare disease, but recognition of the disease in immunocompromised patient s and the prompt initiation of appropriate treatments based on isolation of the pathogen can lead to a successful outcome.