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Systemic Lupus Erythematosus Associated With Pulmonary Nocardiosis

Richard J. Santen, MD; Irving S. Wright, MD
Arch Intern Med. 1967;119(2):202-205. doi:10.1001/archinte.1967.00290200126013.
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MANIFESTATIONS of pulmonary disease in patients with systemic lupus erythematosus reflect a spectrum of etiologic processes ranging from collagen vascular pneumonitis to bacterial, tuberculous, and fungal pneumonitis.1-3 The use of chronic adrenocorticoid therapy predisposes to uncommon infectious pneumonitides which are difficult to distinguish clinically from the primary pulmonary disease of lupus. This case report illustrates the association of systemic lupus erythematosus with an infrequently encountered pathogen, Nocardia asteroides. Previous reports have noted this association on only three occasions.4-6

Report of Case  A 27-year-old man entering the New York Hospital on Sept 16, 1965, had a nine-year history of Raynaud's phenomenon, and a persistent malar erythematous rash for five years. In July 1965, he developed malaise, generalized lymphadenopathy, anemia, and albuminuria. No diagnosis was ascertained during hospitalization elsewhere. One week after discharge on July 2, 1965, a high fever and pleuritic pain in the right side of the


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