Abstract
We report a case of necrotizing pneumonia and empyema in a woman with colon adenocarcinoma, which developed shortly after receiving chemotherapy. A chest tube was placed, and analysis of the pleural fluid identified Nocardia otitidiscaviarum. The patient underwent pleural decortication via video-assisted thoracoscopy and was treated with a combination of trimethoprim-sulfamethoxazole and imipenem/cilastatin. After four weeks of treatment, the patient was discharged with oral trimethoprim-sulfamethoxazole, with no recurrence noted during follow-up. Nocardia otitidiscaviarum is an uncommon pathogen that can cause both localized and disseminated disease, similar to other Nocardia species. Its susceptibility to various antibiotics is variable, making susceptibility testing essential when available, along with close monitoring for potential medication side effects.