Nocardiosis presenting as an anterior mediastinal mass in a patient with sarcoidosis
Jastrzembski, S.A.; Teirstein, A.S.; Herman, S.D.; DePalo, L.R.; Lento, P.A.
Mount Sinai Journal of Medicine new York 69(5): 350-353
2002
ISSN/ISBN: 0027-2507 PMID: 12415330 Document Number: 542660
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.