Nocardiosis and Pulmonary Alveolar Proteinosis

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Abstract
Two cases of nocardiosis, one pulmonary and one cerebral, associated with pulmonary alveolar proteinosis, are described, and the relevant literature reviewed. The former died despite treatment with steroids while the latter recovered with specific therapy. A review of the literature disclosed five previous examples of the coincident appearance of pulmonary alveolar proteinosis and nocardial infection. In one of these the nocardial infection was confined to the brain, and in none was steroid therapy reported. It is considered probable that patients with pulmonary alveolar proteinosis provide an advantageous milieu for the opportunistic invasion by Nocardia. A relationship between steroid therapy and microbiol superinfection, frequently referred to in the literature, is not supported in this study.

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