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Corticosteroid treatment is the globally preferred therapeutic strategy for IPH; however, it can cause immunodeficiency. <jats:italic>Nocardia<\/jats:italic> infection often occurs in immunocompromised patients and primarily involves the pleura and lungs. Herein, we describe a case of pediatric pulmonary Nocardia infection after the corticosteroid treatment of IPH.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 7-year-old girl presented with chief complaints of pale complexion persisting for 1\u00a0year and a cough for 20\u00a0days. Abundant hemosiderin-laden macrophages were detected in the gastric juice, which supported the diagnosis of IPH. Uninterrupted doses of corticosteroids were administered during the last hospitalization. After nearly 2\u00a0months of corticosteroids therapy, the patient began to cough and produce a purulent sputum. Next-generation sequencing of the bronchoalveolar lavage fluid revealed <jats:italic>Nocardia abscessus<\/jats:italic> (<jats:italic>N. abscessus<\/jats:italic>) DNA. Linezolid was administered with good response, and the patient was discharged after 18\u00a0days of hospitalization. Her symptoms and pulmonary lesions had recovered, and the IPH appeared to be well-controlled with low dose of corticosteroids in follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Nocardia infection should be considered in the differential diagnoses for IPH patients receiving corticosteroid therapy, especially in patients with poor response to conventional empirical antibiotic therapy. Next-generation sequencing of bronchoalveolar lavage fluid may be used to quickly identify the Nocardia. Sulfonamides or linezolid are effective for pediatric pulmonary Nocardia infection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-021-01544-0","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T15:19:06Z","timestamp":1624547946000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pulmonary Nocardia infection in a child with idiopathic pulmonary hemosiderosis"],"prefix":"10.1186","volume":"21","author":[{"given":"Lu","family":"Qin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei-Zhou","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong-Yu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Fen","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-7066","authenticated-orcid":false,"given":"Lan-Fang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"issue":"12","key":"1544_CR1","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1007\/BF01958645","volume":"154","author":"S Ohga","year":"1995","unstructured":"Ohga S, Takahashi K, Miyazaki S, Miyazaki S, Ueda K. 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The farther has written the consent form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"There is no any competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"182"}}