Wang HJ, Zhang YN, An L. Clinical and radiographic feature of pulmonary nocardiosis: A study of 102 cases. World J Radiol 2026; 18(1): 114552 [DOI: 10.4329/wjr.v18.i1.114552]
Corresponding Author of This Article
Li An, Professor, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, No. 8 Gongti South Road, Beijing 100020, China. bjzy818@sina.com
Research Domain of This Article
Infectious Diseases
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 28, 2026 (publication date) through Jan 28, 2026
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Publication Name
World Journal of Radiology
ISSN
1949-8470
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wang HJ, Zhang YN, An L. Clinical and radiographic feature of pulmonary nocardiosis: A study of 102 cases. World J Radiol 2026; 18(1): 114552 [DOI: 10.4329/wjr.v18.i1.114552]
World J Radiol. Jan 28, 2026; 18(1): 114552 Published online Jan 28, 2026. doi: 10.4329/wjr.v18.i1.114552
Clinical and radiographic feature of pulmonary nocardiosis: A study of 102 cases
Hui-Juan Wang, Yi-Ning Zhang, Li An
Hui-Juan Wang, Yi-Ning Zhang, Li An, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China
Author contributions: Wang HJ wrote the manuscript; Wang HJ and An L designed the study; Zhang YN collected the patients’ clinical data; and all authors have read and approved the final version.
Supported by the Hospital-Level Incubation Project, No. CYFH202318; the National Major Science and Technology Project of the National Health Commission, No. 2024ZD0529603; and Beijing Tech Nova Program Cross-Cooperation Project.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, approval No. 2025-ke-359.
Informed consent statement: All patients gave their full informed consent for participation in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author bjzy818@sina.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li An, Professor, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, No. 8 Gongti South Road, Beijing 100020, China. bjzy818@sina.com
Received: September 28, 2025 Revised: October 24, 2025 Accepted: December 11, 2025 Published online: January 28, 2026 Processing time: 119 Days and 21.7 Hours
Abstract
BACKGROUND
Nocardia pneumonia is an infection that occurs in patients with underlying diseases. Previously, due to limited detection methods, its detection rate and typing posed significant challenges. However, with advancements in detection techniques, the detection rate has significantly increased, and different Nocardia species exhibit distinct imaging characteristics.
AIM
To retrospectively analyze the etiological and imaging features of pulmonary Nocardia pneumonia and to examine the differences in chest imaging manifestations among different Nocardia species.
METHODS
The medical records of 102 patients with pulmonary nocardiosis who were admitted to Beijing Chaoyang Hospital from January 2017 to December 2024 were collected. Data including name, gender, underlying comorbidities, etiological characteristics, diagnostic methods, chest computed tomography features, and therapeutic agents were recorded.
RESULTS
Among the 102 patients, 55 were male and 47 were female, with a median age of 61 years. Bronchiectasis was the most common comorbidity, observed in 54 patients (52.9%). Sixty percent were diagnosed using metagenomic next-generation sequencing. Nocardia gelsenkin was the most prevalent Nocardia specie, while Aspergillus and Pseudomonas aeruginosa were identified as the predominant co-pathogens in these pulmonary nocardiosis cases. Pneumonia caused by Nocardia wallacei primarily presented with bronchopneumonia as the main imaging feature, while other Nocardia species more commonly manifested as consolidation, often accompanied by nodules, cavities, and pleural effusion. The imaging features in immunosuppressed patients were more diverse, with frequent coexistence of multiple patterns.
CONCLUSION
Nocardia pneumonia commonly coexists with bronchiectasis. While metagenomic next-generation sequencing has greatly enhanced its detection rate, Nocardia wallacei pneumonia is distinguished on chest computed tomography by its primary presentation of bronchopneumonia, unlike other types.
Core Tip: This study highlights that bronchiectasis is the most common comorbidity in pulmonary nocardiosis. Metagenomic next-generation sequencing is a key diagnostic tool. Crucially, chest computed tomography reveals distinct imaging patterns: Nocardia wallacei primarily presents as bronchopneumonia, while other species more frequently cause consolidation with nodules/cavities. Immunosuppressed patients exhibit more diverse and complex imaging features.
