Progressive pneumonia complicating steroid-dependent asthma.

We describe a patient who developed pulmonary nocardiosis whilst taking long term oral steroids for asthma. Nocardiosis is more common than is generally appreciated by clinicians, is notoriously difficult to diagnose, and is associated with significant mortality. This patient developed progressive pneumonia despite antibiotic therapy, which is typical of pulmonary nocardiosis. It is important to consider this treatable condition in the differential diagnosis of pneumonia.