Fibrous Cavity in an Immunocompromised Lung: Nocardiosis Masquerading as Tuberculosis

Nocardia species can cause fulminant necrotizing cavitary pneumonia. Diagnosis involves identification of the organism, speciation, and correlating with appropriate clinical and radiological findings. Speciation is often difficult due to the complexities involved in culturing the organism. Treatment involves administering antibiotics for a prolonged duration. The authors hereby report a case of pulmonary nocardiosis in a patient who had premorbidities such as cirrhosis of the liver and membrano-proliferative glomerular nephritis on immunosuppression with high dose corticosteroids making him vulnerable to the organism.