Nocardiosis with diffuse involvement of the pleura: A case report

Figure 1 Axial computed tomography showed many nodular or hillock lesions in the right pleura, mediastinum, and interlobar fissure areas. A and B: At the upper level of the lung, the lesions were located in the right pleural and mediastinum areas; C and D: At the middle level of the lung, the lesions were located in the right pleura, mediastinum, and interlobar fissure areas (arrow); E and F: At the lower level of the lung, the lesions were located in the right pleura and mediastinum areas with atelectasis of adjacent lung.

Figure 2 Sagittal computed tomography showed many nodular or hillock lesions in the right pleura, mediastinum, and interlobar fissure areas. A and B: The lesions were located in the right pleura and interlobar fissure areas (arrow); C and D: The lesions were located in the right pleura and mediastinum areas.

Figure 3 Coronal computed tomography showed many nodular or hillock lesions in the right pleura, mediastinum, and interlobar fissure areas. A and B: The lesions were located in the right pleura, mediastinum, and interlobar fissure areas (thin arrow); C and D: The lesions were located in the right pleura and mediastinum areas. On the lower layer, one lesion infiltrated the chest wall, and the adjacent liver was compressed (thick arrow).

Figure 4 Gram staining and weak acid-fast staining of the bacteria. A: Gram staining showed filamentous, branching Gram-positive bacilli; B: The bacteria were positive for weak acid-fast staining.

Figure 5 Axial computed tomography showed that the lesions were obviously improved in terms of absorption after 1 mo of treatment. A and B: At the upper level of the lung, the lesions located in the right pleural and mediastinum areas were significantly reduced; C and D: At the middle level of the lung, the lesions located in the right pleura, mediastinum, and interlobar fissure areas were significantly reduced; E and F: At the lower level of the lung, the lesions located in the right pleura and mediastinum areas were significantly reduced and atelectasis of adjacent lung was markedly improved.