Pulmonary nocardiosis in a patient with a bone marrow transplant. Bone Marrow Transplantation Team.

Infection with nocardia is rare in BMT patients. We described the first reported case of pulmonary nocardiosis in an allogeneic marrow recipient with graft-versus-host disease. The patient developed nocardial infection while receiving trimethoprim-sulfamethoxazole as prophylaxis against Pneumocystis. The salient clinical presentation was right lower lung consolidation; the diagnosis was established by prolonged incubation of an open lung biopsy specimen. Antibiotic therapy included timentin and later, imipenem. However, the patient died with uncontrolled infection. Necropsy revealed nocardial lung abscesses and disseminated infection from cytomegalovirus.