Weekly Chest CasesArchive of Old Cases

Case No : 549 Date 2008-05-05

  • Courtesy of Jung Im Jung, MD. / St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea.
  • Age/Sex 19 / F
  • Chief ComplaintFever and pleuritic chest pain, Phx; Rhematoid arthritis and chronic renal failure.
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Nocardiosis
Radiologic Findings
Chest radiograph shows multiple nodular opacities along the pleural surface and some effusion in R lower thorax.

Non-contrast chest CT scan shows multiple, variable-sized, subpleural lung nodules and right pleural effusion in the lower thorax.

Tissue pathology shows fibrinoid necrosis with neutrophils and granulomatous inflammation. On culture of pleural aspirates, gram-positive, filamentous branching rods of nocardia were identified.
Brief Review
Please refer to
Case 76, Case 117,
KSTR Symposium 1998  Case 10 ,
KSTR Symposium 1999  Case 8 ,
KSTR Imaging Conference 2001 Spring  Case 11 ,
KSTR Imaging Conference 2002 Spring  Case 4 ,
 
References
Keywords
Pleura, Lung, Infection, Bacterial infection,

No. of Applicants : 79

▶ Correct Answer : 11/79,  13.9%
  • - China Medical University,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - Chungnam National University hospital , Korea (South) Kyoung Jin Oh
  • - Mackay Memorial Hospital , Taiwan Shen ShengYeh
  • - Dongguk University International Hospital , Korea (South) Hee Seok Choi
  • - Asan Medical Center , Korea (South) Eun Jin Chae
  • - Homs National Hospital , Syria Rami Abou zalaf
  • - Gimpo Woori Hospital , Korea (South) Son Youl Lee
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - IRSA LA ROCHELLE FRANCE , France jean-luc BIGOT
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Depatment of Radiology, Yongsan Hospital, College of Medicine, Chung-Ang University , Korea (South) Jae Seung Seo
▶ Correct Answer as Differential Diagnosis : 3/79,  3.8%
  • - radiology department ANNECY , France gilles GENIN
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - All India Institute of medical sciences , India Justin Moses
▶ Semi-Correct Answer : 27/79,  34.2%
  • - Osaka University , Japan Osamu Honda
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - The Armed Forces HamPyeong Hospital , Korea (South) Bae Geun Oh
  • - Konkuk university hospital , Korea (South) Jeong Geun Yi
  • - EKH-Berlin , Germany Michael Weber
  • - Almana.G.Hospital , Saudi Arabia Jamal Abazid
  • - Pe d , France Fabrice Bing
  • - Saga University, Japan , Japan Ryoko Egashira
  • - E-DA Hospital / I-Shou University , Taiwan Yu-Feng Wei
  • - Catholic Medical Center , Korea (South) Min Sung Kim
  • - Cheongshim international medical center , Korea (South) yang Hae Jum
  • - hospital Sao Paulo , Brazil israel missrie
  • - Mackay Memorial Hospital, Taipei, Taiwan , Taiwan Chia-Fu Tsai
  • - Jackson Memorial Hospital , United States Naganathan Mani
  • - MAX HEALTH CARE , India vickrant malhotra
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - IRSA La Rochelle France , France Denis Chabassie
  • - CH de la Ce Basque , France Paul ARDILOUZE
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - Apollo Hospital, Ahmedabad. , India Dr. Sandip R Shah
  • - Armed Forces Chun-Cheon Hospital , Korea (South) ChaeHun Lim
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
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