Case Report: Pulmonary nocardiosis: three case reports and literature review
Abstract
Pulmonary nocardiosis is a relatively uncommon opportunistic infection characterized by nonspecific clinical features, often leading to delays in diagnosis and treatment. We describe the clinical data of three confirmed cases of pulmonary Nocardia infection. We also systematically reviewed relevant literature from the PubMed database between January 2015 and September 2025, and performed a pooled analysis of 119 patients. Case 1 involved an elderly patient with bronchiectasis, diagnosed via targeted next-generation sequencing (tNGS) of sputum, who showed significant radiological improvement after treatment with trimethoprim-sulfamethoxazole. Case 2, with coexisting bronchiectasis and chronic obstructive pulmonary disease, was diagnosed by tNGS of bronchoalveolar lavage fluid and switched to linezolid-based combination therapy due to drug intolerance. Case 3 involved a patient with underlying structural lung disease who experienced protracted infection but eventually achieved control following individualized combination antimicrobial therapy and supportive care. Literature analysis revealed a median age of 57 years with a male predominance (55.5%). Common comorbidities included chronic lung diseases (39.5%) and immunosuppression-related conditions (39.5%). Chest CT findings mainly featured consolidation (47.9%) and nodules (41.2%). Diagnosis relied primarily on sputum/airway secretions (48.7%) and bronchoalveolar lavage fluid (42.9%), and 83.2% of patients received regimens…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 119 participants or records.
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