18F-FDG Imaging of a Case of Disseminated Nocardiosis

Nocardiosis is an uncommon infection caused by ubiquitous environmental aerobic gram-positive filamentous bacteria, present in soil and water. Skin and lungs are usually the main targets of localized infections. Rarely, disseminated forms can occur in immunocompromised individuals. A 63-year-old man with a history of late-onset asthma and nasal and sinus polyposis treated with oral low-dose corticosteroid regimen presented with fever, headache, myalgia, skin erythematous plaques, and pustules. Brain MRI revealed multiple abscesses and pachymeningitis. F-FDG PET/CT was performed to assess the extent of the infection. Cutaneous samples and sputum culture isolated Nocardia brasiliensis, confirming diagnosis of disseminated nocardiosis.