PDF(Pubmed)
Abstract：
A woman in her 70s with a history of nodular bronchiectatic Mycobacterium avium complex pulmonary disease (MAC-PD) presented with an exacerbated productive cough and worsening findings on chest imaging. Although repeated sputum culture tests were negative for acid-fast bacilli and only revealed normal respiratory flora, a bronchoscopy identified Nocardia sp. Consequently, she was diagnosed with pulmonary nocardiosis and was successfully treated with levofloxacin. It is known that pulmonary nocardiosis can manifest in immunocompetent individuals with bronchiectasis. For cases of refractory nodular bronchiectatic MAC-PD, it is vital to consider bronchoscopy to identify potential co-infections, such as Nocardia.
摘要：
一名70多岁的女性，有结节性支气管结核分枝杆菌复合肺病（MAC-PD）的病史，表现为咳嗽加剧，胸部影像学检查结果恶化。尽管反复痰培养试验对抗酸杆菌呈阴性,只显示呼吸道菌群正常,支气管镜检查确定诺卡氏菌。因此,她被诊断为肺诺卡心症，并成功接受了左氧氟沙星治疗。已知肺诺卡心症可以在具有支气管扩张的免疫活性个体中表现出来。对于难治性结节性支气管哮喘MAC-PD，考虑支气管镜检查以确定潜在的合并感染是至关重要的，比如诺卡氏菌.
