Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient

Table 2

Summary of pulmonary nocardiosis cases presented as endobronchial mass.

Number	Age/sex	Smoking status	Clinical presentation	CXR/CT	Bronchoscopic findings	Identified species	Main treatment
1	73/male	Ex-smoker	Cough, fever, malaise, night sweats, and weight loss	Air space opacity RUL	Polypoid mass at the RUL [21]	Nocardia asteroides	TMP-SMX therapy, for 6 months
2	51/male	Ex-smoker	Malaise, low grade fever, chills, and cough	Infiltrate in the anterior segment of RUL	White exophytic lesion occluding the anterior segment RUL [22]	Nocardia asteroides	TMP-SMX therapy, for 3 months
3	28/male	Nonsmoker	Cough, fever, malaise, weight loss, night sweats, and dyspnea	Paramediastinal mass occluding RMB	Large fungating mass extending from the RMB [23]	Nocardia asteroides	Triple-sulfa therapy, for 6 months, gentamicin, for 3 months. RUL lobectomy
4	56/male	Ex-smoker	Cough, night sweats, and malaise	Left lung infiltrate	Mucosal edema and endobronchial mass [24]	Nocardia asteroides	Sulfisoxazole therapy, for 1 year
5	32/female	Unspecified	Fever, cough, and hemoptysis	RUL thick wall cavity with suspected fungal ball inside [25]	No bronchoscopy, on thoracotomy, fungal ball on RLL segments	Nocardia sp.(unspecified)	RML and RLL resection(unspecified antibiotics)
6	70/male	Smoker	Cough, dyspnea, anorexia, and weight loss	Mass in the RUL bronchus	Obstructing “tumor” of the RMB [26]	Nocardia asteroides	Minocycline, for 10 months
7	25/female	Nonsmoker	Persistent cough, pleuritic chest pain, and hemoptysis	Infiltrates RUL, RML, and RLL pleural effusion	Friable lesion “pearly white” occluding the entire segment [27]	Nocardia sp.(unspecified)	Antituberculosis medication. TMP-SMX therapy (unspecified duration)
8	55/female	Ex-smoker	Cough, weight loss, and hemoptysis	Endobronchial mass and cavitary lesion	Friable weight material, our case	Nocardia beijingensis	TMP-SMX therapy, for 3 months, ceftriaxone, for 1 month

RUL, right upper lobe; RML, right middle lobe; RLL, right lower lobe; RMB, right middle bronchus of lung; TMP-SMX, trimethoprim-sulfamethoxazole.
All patients had symptoms resolution after initiating the appropriate treatment, except in case 5 where the patient died due to late diagnosis.