2025 Volume 14 Issue 2 Pages 72-76
A 66-year-old woman who had received a corticosteroid and an immunosuppressant with a preventative sulfamethoxazole/trimethoprim oral tablet for the overlap of rheumatoid arthritis and dermatomyositis-associated interstitial lung disease was admitted to our institution for right-sided chest pain and dyspnea. Sputum yielded Nocardia pseudobrasiliensis, and we administered levofloxacin according to the results of drug-sensitivity testing using the disk diffusion method. She improved temporarily, but then her symptoms worsened again. She developed nodules in her brain along with thyroid and multiple pulmonary nodules. Aspirates obtained from her thyroid under computed tomography guidance yielded N. pseudobrasiliensis. After her antibiotics were switched based on results obtained using the broth microdilution method, her condition improved, and she was then transferred to another hospital.
