Case 72. Nocardiosis of lung (25 y-o M)
         
    Bronchial lavage from cavity-forming pneumonia in a patient with ulcerative colitis receiving corticosteroid    
         
   
Key words : Nocardia asteroides, lung abscess, ulcerative colitis, steroid
   
         
   
opportunistic infection
   
     
 
     
Grocott-stained cytological preparation reveals thin, filamentous and lamifying argyrophilic bacteria, strongly suggestive of nocardiosis.   The filamentous bacteria are Gram-positive. Following cytologist's suggestion, microbial culture identified Nocardia asteroides in the sputum.
     
 
     
Transbronchial lung biopsy from the same patient
Transbronchial lung biopsy reveals focal necrotizing exudation, consisting of fibrin and neutrophils (HE). Grocott and Gram stains were negative in this material. N. asteroides is aerobic, while A. israelii is anerobic.
  Reference case 72A
Autopsied lung of nocardiosis in AIDS (36 y-o male). Necrotizing inflammation (abscess formation) is observed (HE). In contrast to actinomycosis, no grains are formed in nocardiosis.
     
   
     
Reference case 72A
Autopsied lung of nocardiosis in AIDS (36 y-o male). Grocott stain demonstrates numerous thin, filamentous, lamifying bacteria. N. asteroides is an opportunistic pathogen for immunocompromised hosts.