[Nocardiosis as a differential diagnosis of a PET-positive pulmonary nodule]. / Nokardiose als Differenzialdiagnose eines PET-positiven Lungenherdes.

ABSTRACT

We describe the case of a 76-year-old immunocompetent man suspected to have lung cancer in the right upper lobe on the basis of radiographic and clinical findings. The tumour could not be confirmed histologically by transbronchial biopsy. In the fluorodeoxyglucose positron emission tomography (FDG-PET) we found a significantly elevated standard uptake value (SUV) of 13.4. The patient underwent thoracotomy with excision of the tumour, the histological diagnosis was chronic pneumonia. Tissue culture revealed Nocardia spp. Using 16-rDNA-gene sequence analysis the species was identified as Nocardia abscessus. The patient was treated with trimethoprim-sulfamethoxazol regarding the susceptibility profile and improved remarkably both clinically and radiographically.