Respir Case Rep. 2018; 7(2): 127-130 | DOI: 10.5505/respircase.2018.10337

Unexplained Pleural Infection in an Immunosuppressive Patient: Nocardiosis

Gamze Göker¹, Ahmet Emin Erbaycu¹, Mine Gayaf¹, Dursun Alizoroðlu¹, Soner Gürsoy², Mete Demirel^3
1The Department Of Chest Diseases, Ýzmir Training And Research Hospital For Thoracic Medicine And Surgery, Ýzmir, Turkey
²The Department Of Chest Surgery, Izmir Training And Research Hospital For Thoracic Medicine And Surgery, Izmir, Turkey
³The Department Of Microbiology, Izmir Training And Research Hospital For Thoracic Medicine And Surgery, Izmir, Turkey

Pleural involvement in nocardiosis is rare and usually accompanies pulmonary paranchymal involvement. In the case presented here, the patient had been treated with a systemic corticosteroid for a long time for temporal arteritis. He was continuing the treatment when he was referred to our clinic for a diagnosis of the pleural disease. Following a positive pleural culture result for Nocardia, trimethoprim/sulfamethoxazole treatment was initiated. Clinical and radiological improvement was observed with treatment. Pleural nocardiosis should be kept in mind in the differential diagnosis of cases of pleural effusion with an unknown origin, particularly among immunosuppressed patients.

Keywords: Pleural nocardiosis, pleural effusion, corticosteroid, immunsupression.

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Ýmmünsüpresif bir hastada açýklanamayan plevral infeksiyon: Nocardiozis

Gamze Göker¹, Ahmet Emin Erbaycu¹, Mine Gayaf¹, Dursun Alizoroðlu¹, Soner Gürsoy², Mete Demirel^3
1Ýzmir Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Kliniði, Ýzmir
²Ýzmir Dr Suat Seren Göðüs Hastalýklarý Ve Cerrahisi Eðitim Ve Araþtýrma Hastanesi, Göðüs Cerrahisi Kliniði, Ýzmir
³Ýzmir Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Mikrobiyoloji Bölümü, Ýzmir

Plevral Nocardiosis nadir bir plevral tutulumdur ve genellikle akciðer parankim tutulumu ile birliktedir. Sunulan hasta temporal arterit nedeniyle uzun süreli sistemik kortikosteroid tedavisi almýþtýr. Tedavisi halen sürerken plevral sývýnýn teþhisi için kliniðimize yönlendirilmiþtir. Plevral sývýnýn kültüründe Nocardia üremesi üzerine trimetoprim-sulfametaksazol tedavisi baþlanmýþtýr. Tedavi ile klinik ve radyolojik iyileþme gözlenmiþtir. Plevral Nocardiozis, immünsüprese hastalarda nedeni açýklanamayan plevral sývýlarýn ayýrýcý tanýsýnda akla getirilmelidir.

Anahtar Kelimeler: Plevral nocardiozis, plevral sývý, kortikosteroid, immünsüpresyon.

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Image Slices of the Case

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