Nocardiosis, a Case Report

A 45 y/o man, a known case of chronic lymphocytic leukemia from 2 years ago, presented with chief complaint of productive cough and fever from 2 months ago. the patient is a known case of chronic lymphocytic leukemia, followed by hematologist and received prednisolon 5mg, po, tid, and with this medication was in remission. he was relatively well up to about 2 months ago, when developed low grade fever associated with productive cough. so he referred to a general physician and received some medication without any improvement. during this period of time he developed anorexia and weight loss about 4-5 kg and his condition become worsen with generalized weakness and malaise. so he referred to a pulmonologist and a chest x-ray was recommended by him which showed infiltrations in both upper lobe with cavity formation (fig 1). so the patient was admitted in pulmonary ward of faghihi hospital for better evaluation. in physical examination on admission, the patient was febrile with temperature of 38-38.5?c, he had some trash on buccal mucosa and throat but chest physical examination was completely normal. so due to findings in chest x-ray with impression of bacterial pneumonia he received some antibiotics such as ceftazidim and amikacin.