CASE REPORT article
Front. Med.
Sec. Pulmonary Medicine
Massive Hemoptysis as the Sentinel Symptom: A Case Report of Pulmonary Nocardiosis in an Immunocompetent Patient
Provisionally accepted
- 1The First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, China
- 2Shuguang Anhui Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, hefei, China
- 3The First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei, China
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Pulmonary nocardiosis is frequently missed or misdiagnosed due to its atypical clinical symptoms and non-specific imaging findings. Moreover, delayed diagnosis and treatment can lead to high mortality rates, underscoring the need to enhance etiological diagnosis. Here, we report a 55-year-old immunocompetent woman who developed pulmonary Nocardia cyriacigeorgica infection with massive hemoptysis as the initial symptom. The patient had no history of chronic respiratory diseases. Metagenomic next-generation sequencing of bronchoalveolar lavage fluid collected via bronchoscopy was performed, which confirmed the diagnosis. After targeted therapy with oral sulfamethoxazole-trimethoprim and linezolid, the patient achieved significant symptomatic and radiological improvement, accompanied by normalization of white blood cell count and neutrophil count. No recurrence was observed during follow-up.
Keywords: Pulmonary Nocardiosis, Nocardia cyriacigeorgica, Infection, Immunocompetent patient, Hemoptysis
Received: 31 Jul 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 Zhang, 巩, Sun and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huizhi Zhu, zhuhz825@163.com
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