Pulmonary nocardiosis associated with primary nocardial infection of the oral cavity

A case of pulmonary nocardiosis associated with primary nocardial infection of the oral cavity in a compromised host is presented. Nocardia asteroides, an aerobic, gram-positive, branching, filamentous fungus, was demonstrated in the sputum and in pathologic specimens from gingival sulci stained by Gram's method and the acid-fast method of Kinyoun. The organism was identified in cultures made on Sabouraud's glucose agar. Marked clinical improvement was noted when the patient received high dosages of sulfisoxazole diolamine (8 to 12 Gm. per day) for a prolonged period of time (9 to 12 months). Because of an apparent relative increase in the incidence of nocardiosis and a paucity of information on the subject in the dental literature, this article is timely.