Pleural Infection Caused by Nocardia farcinica: Two Cases and Review of the Literature

Nocardia farcinica is a rare Nocardia species causing localized (lung, brain, skin) and disseminated infections. Predisposing factors include the chronic use of corticosteroids, organ transplantation and other immunocompromise conditions. Pleural empyema caused by this microorganism has scantily been reported. We describe two cases of pleural infection by N. farcinica that occurred in patients with a kidney transplant and cirrhosis, respectively. The first patient died soon after hospitalization, while the second survived nocardiosis (despite having significant adverse events to antibiotics) but eventually succumbed to other infectious complications. In this infectious disease, in which the duration of therapy is typically long and pleural space drainage is frequently required, bacterial susceptibility to antimicrobial agents should be tested.