{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:55:41Z","timestamp":1789422941506,"version":"build-2803163510"},"reference-count":121,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Pulmonary nocardiosis is a relatively uncommon opportunistic infection characterized by nonspecific clinical features, often leading to delays in diagnosis and treatment. We describe the clinical data of three confirmed cases of pulmonary\n                    <jats:italic>Nocardia<\/jats:italic>\n                    infection. We also systematically reviewed relevant literature from the PubMed database between January 2015 and September 2025, and performed a pooled analysis of 119 patients. Case 1 involved an elderly patient with bronchiectasis, diagnosed via targeted next-generation sequencing (tNGS) of sputum, who showed significant radiological improvement after treatment with trimethoprim-sulfamethoxazole. Case 2, with coexisting bronchiectasis and chronic obstructive pulmonary disease, was diagnosed by tNGS of bronchoalveolar lavage fluid and switched to linezolid-based combination therapy due to drug intolerance. Case 3 involved a patient with underlying structural lung disease who experienced protracted infection but eventually achieved control following individualized combination antimicrobial therapy and supportive care. Literature analysis revealed a median age of 57\u202fyears with a male predominance (55.5%). Common comorbidities included chronic lung diseases (39.5%) and immunosuppression-related conditions (39.5%). Chest CT findings mainly featured consolidation (47.9%) and nodules (41.2%). Diagnosis relied primarily on sputum\/airway secretions (48.7%) and bronchoalveolar lavage fluid (42.9%), and 83.2% of patients received regimens containing trimethoprim-sulfamethoxazole. Patients undergoing next-generation sequencing and\/or bronchoscopy showed a trend toward lower mortality. This report suggests that a precision pathogen diagnosis strategy centered on bronchoscopy and next-generation sequencing, combined with susceptibility-guided and dynamically adjusted individualized combination antimicrobial therapy, may help improve clinical outcomes in patients with pulmonary nocardiosis. Close monitoring and management of adverse drug reactions are essential during long-term treatment.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1789986","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T06:57:18Z","timestamp":1773817038000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Pulmonary nocardiosis: three case reports and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Qi","family":"Zhao","sequence":"first","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xincheng","family":"Nie","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LIna","family":"Fu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehao","family":"Fu","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.jgar.2024.02.008","article-title":"The first reported pulmonary 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