Pulmonary Nocardiosis in a patient with recurrent COPD exacerbations

Pulmonary nocardiosis is a rare infection with a high mortality rate. We present a case of an elderly male with severe COPD treated with repeated courses of prednisone and highlight specific factors predisposing to a Nocardia infection. We review literature data and advocate for early invasive testing to direct management. We underline the role of early bronchoscopy in this select population given its safety and potential diagnostic yield.