A case of disseminated infection with Nocardia brasiliensis in a lung transplant recipient.

Background: Infection with Nocardia species is an increasingly recognized complication of solid organ transplantation. Nocardia asteroides accounts for most transplant-related nocardiosis, while Nocardia brasiliensis rarely causes infection in organ transplant recipients.

Methods: We describe a case of disseminated infection with N brasiliensis in a single-lung transplant recipient who also had concomitant infections with viral and fungal organisms.

Results: Although the mortality rate is high in immunocompromised patients with disseminated Nocardia infection, our patient responded favorably to prolonged antimicrobial therapy.

Conclusions: This case illustrates that N brasiliensis, like N asteroides, produces pulmonary disease and dissemination in solid organ transplant recipients, and demonstrates the utility of prolonged treatment with trimethoprim-sulfamethoxazole in Nocardia infections.