{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T04:13:31Z","timestamp":1793506411538,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Pfizer Global Medical Grants","award":["76080151"],"award-info":[{"award-number":["76080151"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Pulmonary nocardiosis (PN) is a rare, opportunistic, and potentially life-threatening infection, especially in disseminated cases. This retrospective study aimed to characterize the clinical features of PN and assess the diagnostic utility of metagenomic next-generation sequencing (mNGS). We reviewed data from 19 patients diagnosed with PN between September 2019 and August 2022, including 3 with disseminated disease. Common symptoms included fever, cough, and sputum production, while chest imaging frequently revealed nodules, consolidations, exudates, cavities, and pleural effusions. The sensitivity of mNGS for detecting Nocardia was significantly higher than that of culture (100% vs. 36.84%, p &lt; 0.001). mNGS successfully identified Nocardia species and co-infected pathogens. The most common species was Nocardia farcinica. Four PN cases were co-infected with Rhizomucor pusillus, Cryptococcus neoformans, Lichtheimia ramosa, and Aspergillus spp. Eighteen patients (94.7%) received trimethoprim-sulfamethoxazole (TMP-SMZ). Sixteen cases (84.2%) were improved or cured. Misdiagnosis is common due to the nonspecificity of clinical and imaging presentations of pulmonary nocardiosis. The timely combination of mNGS represents a promising approach to enhance the diagnosis of pulmonary nocardiosis and inform targeted antimicrobial therapy. TMP-SMZ is the first line of treatment.<\/jats:p>","DOI":"10.3390\/pathogens14070656","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T06:10:26Z","timestamp":1751436626000},"page":"656","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Features of Pulmonary Nocardiosis and Diagnostic Value of Metagenomic Next-Generation Sequencing: A Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Yanbin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailong","family":"Fu","sequence":"additional","affiliation":[{"name":"Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiongfang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalu","family":"Ren","sequence":"additional","affiliation":[{"name":"Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical, Nanjing Dinfectome Technology Inc., Nanjing 210032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"Wu","sequence":"additional","affiliation":[{"name":"Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[{"name":"Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University, 899#, Pinghai Road, Suzhou 215031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/MCP.0b013e3282f85dd3","article-title":"Pulmonary nocardiosis: Risk factors, clinical features, diagnosis and prognosis","volume":"14","author":"Reyes","year":"2008","journal-title":"Curr. 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