Nocardia:
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The patient is an elderly man with a history of lymphoma that presents with fever, cough, and an elevated white blood cell count.
The initial chest radiograph demonstrated a left lower lobe infiltrate.
The patient was treated with a course of antibiotics with some clinical improvement, but a follow-up chest radiograph demonstrated that the infiltrate had enlarged and appeared mass-like.
A CT scan of the chest demonstrated a large, cavitary infiltrate extending to the pleural surface within the left lower lobe. Sputum cultures and bronchoalveolar lavage yielded no organisms. Norcardia was cultured from a percutaneous specimen.
