Volume 69 Number 5 October 2002	back to contents

Nocardiosis Presenting as an Anterior Mediastinal Mass in a Patient with Sarcoidosis	350-353
Stasia A. Jastrzembski, M.D.1, Alvin S. Teirstein, M.D.1, Steven D. Herman, M.D.2, Louis R. DePalo, M.D.1, and Patrick A. Lento, M.D.3

¹Division of Pulmonary and Critical Care Medicine, ²Department of Cardiothoracic Surgery, and ³Department of Pathology, Mount Sinai School of Medicine, New York, NY.

Address all correspondence to Alvin S. Teirstein, M.D., Director, Division of Pulmonary and Critical Care Medicine, Mount Sinai School of Medicine, Box 1232, One East 100th Street, New York, NY 10029.

Supported by the Catherine and Henry J. Gaisman Foundation.

Accepted for publication April 15, 2002.

ABSTRACT

We report a patient with tissue-proven sarcoidosis receiving adrenocorticosteroid medication, who developed an enlarging mediastinal mass. Transcutaneous needle biopsy of the mass yielded pus which grew Nocardia asteroides on culture. Pleural effusion, bronchoesophageal fistula and brain nocardia metastases occurred. All evidence of active infection cleared with sulfa therapy. An enlarging mass in a patient with sarcoidosis unresponsive to corticosteroid therapy should provoke studies for other causes of mediastinal disease, including opportunistic infections.

KEYWORDS

Nocardia, nocardiosis, sarcoidosis, prednisone, mediastinal mass.

MSSM Home

Back Issues | Indexes | Search | Journal Home