Nocardiosis: a rare cause of pleuropulmonary disease in the immunocompromised host.

We report a case of acute pleuropulmonary nocardial infection in a 24-year-old woman suffering from systemic lupus erythematosus. In most instances, No-cardia asteroides is an opportunistic pathogen. In our patient, the infection was facilitated by systemic lupus erythematosus and chronic use of corticosteroids and immunosuppressive drugs. N. asteroides was cultured from both pleural effusion and blood. No extrathoracic location was found and the patient improved upon intravenous antibiotics and pleural drainage. Owing to the poor tolerance of trimethoprim/sulfamethoxazole, the patient was treated successfully with imipenem. The predisposing factors, the clues to the diagnosis and the therapy of nocardiosis are briefly reviewed.