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  • Title: Pulmonary nocardiosis concurrent with Pneumocystis carinii pneumonia in two patients undergoing immunosuppressive therapy.
    Author: Perschak H, Gubler J, Speich R, Russi E.
    Journal: J Infect; 1991 Sep; 23(2):183-5. PubMed ID: 1753118.
    Abstract:
    Two cases with concomitant pulmonary nocardiosis and Pneumocystis carinii pneumonia are described. The first patient developed pneumonia 3 months after heart transplantation while undergoing standard immunosuppressive therapy with cyclosporin, azathioprine and prednisone. The second patient was treated with chemotherapy and subsequent radiotherapy of the mediastinum for a malignant epithelial tumour. He also received prednisone for paraneoplastic dermatomyositis. Chest X-rays of both patients showed a bilateral interstitial pattern and broncho-alveolar lavage revealed P. carinii. Additional dense and localised pulmonary infiltrates led to suspicion of a further infectious agent, namely, Nocardia asteroides, which was isolated from both patients. Since nocardiosis calls for prolonged treatment, extensive diagnostic measures are needed for its early detection.
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