Fulminating Pulmonary Nocardiosis

Nocardiosis is a chronic infection of skin, lung, and brain caused in almost all cases by Nocardia asteroides. A fatal case of pulmonary nocardiosis which probably developed while on antibiotic therapy is reported. The mycology, pathology and clinical picture are reviewed. Sulfadiazine in a dose of 4 to 6 gm. daily is the drug of choice and should probably be combined with a broad-spectrum antibiotic. Surgical drainage is a necessary concomitant in the presence of abscesses and empyema.