PT - JOURNAL ARTICLE AU - R Wada AU - C Itabashi AU - Y Nakayama AU - Y Ono AU - C Murakami AU - S Yagihashi TI - Chronic granulomatous pleuritis caused by nocardia: PCR based diagnosis by nocardial 16S rDNA in pathological specimens AID - 10.1136/jcp.56.12.966 DP - 2003 Dec 01 TA - Journal of Clinical Pathology PG - 966--969 VI - 56 IP - 12 4099 - http://jcp.bmj.com/content/56/12/966.short 4100 - http://jcp.bmj.com/content/56/12/966.full SO - J Clin Pathol2003 Dec 01; 56 AB - Nocardiosis is an uncommon infection caused by the aerobic actinomycete nocardia. Identification of the pathogen is essential for the definitive diagnosis and for an effective treatment. This report describes a case of chronic granulomatous pleuritis caused by nocardia. A 59 year old Japanese man had a history of repeated pyothorax. Right pleural decortication and thoracic drainage were performed. Microbiological examinations of the drained fluid failed to identify a pathogen. Pathological examinations revealed Gram positive filamentous and branching bacilli in the granulomatous lesion of the pleura. Sequencing of the 971 bp 16S ribosomal DNA extracted and amplified from paraffin wax embedded sections identified the microorganism as Nocardia sp. IFM 0860. The patient received sulfamethoxazol/trimethoprim and minocycline. Although the presence of a brain abscess was disclosed by systemic examination, the clinical course has been favourable. In this patient, polymerase chain reaction analysis of 16S ribosomal DNA in pathological specimens was useful in making an accurate diagnosis of nocardiosis and in determining the appropriate treatment.