TY - JOUR T1 - Pulmonary nocardiosis (PN) complicating chronic pulmonary diseases JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2468 AU - Marta Díez-Ferrer AU - Yolanda Ruiz AU - Carmen Ardanuy AU - Fe Tubau AU - Jordi Camara AU - Jordi Dorca Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2468.abstract N2 - We reviewed 32 PN consecutive episodes seen in our Department in 10 years. Isolates were studied by sequencing the 900-bp internal fragment of the 16S rRNA gene and susceptibility tests by microdilution (Sensititre®) were repeated. Patient characteristics: 23 (72%) males, 71±14 years, 21 (66%) active/former smokers, moderate-severe COPD in 19 (59%), bronchiectasis in 8 (25%) and ILDs in 5 (16%). Oral/IV steroids in 15 (47%), inhaled steroids in 22 (69%), both in 5 (16%), and none in 6 (19%). Clinical course duration: 2 weeks in 14 (44%), 2-6 weeks in 12 (37%) and 6 weeks in 6 (19%). Clinical picture: productive cough in 26 (81%), fever in 18 (56%) and chest pain in 11 (34%). Rx findings: pseudonodules in 14 (44%), patchy infiltrates in 7 (22%), cavitation in 4 (12%) and no changes in 7 (22%). Empirical ATB: SXT 20 (62%), IPM+AMK 4 (12%), SXT+IPM 2 (6%), IPM 2 (6%), other 4 (14%). Three-month mortality: 10 (31%). Relapse and reinfection in 1 (3%) each.Isolates were identified as: N. abscessus in 11 (34%), N. cyriacigeorgica in 9 (28%), N. otitidiscaviarum in 6 (19%) and N. farcinica, N. transvalensis and Nocardia sp. in 2 (6%) each. Susceptibility: LZD 32 (100%), SXT 31 (97%), AMK 31 (96%), CRO 24 (76%), IPM 16 (51%), AMC 14 (45%), CIP 3 (10%). Resistance to empirical ATB in 4 fatal episodes: SXT in 2, IPM and AMC in 1 each.We conclude: 1) PN is not rare in chronic respiratory patients even without immunodepression. 2) The clinical course is subacute. 3) Rx findings may be not characteristic or even absent. 4) Most common species: N. abscessus, N. cyriacigeorgica and N. otitidiscaviarum. 5) One third of the patients died within 3 months. 6) Resistance to empirical ATB could explain clinical failure in 4 cases. ER -