case_images: PMC11193390_01
case_images: CT image of the patient's lungs.
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case_images: C-reactive protein (46.5 mg/L) were indicated by blood routine examination (Table 1). Computed tomography (CT) scan showed pulmonary inflammation with bronchiectasis (Figure 1).
case_images: Etiological examination: (a) Gram-positive bacteria were observed by Gram staining under an oil mirror (x1,000 magnification); (b) acid-fast staining under oil mirror (x1,000 magnification); (c) wrinkled, dry, and white colonies of different sizes were observed by culture on the blood agar plate; (d) MALDI-TOF MS confirmed it was Nocardia wallacei.
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case_images: j_biol-2022-0891_fig_002
case_images: A large number of Gram-positive filamentous bacteria were observed to be arranged radially, with varying shades of staining resembling beads under oil microscopy, indicating that it may be of the genus Nocardia (Figure 2a). Acid-fast staining was weakly positive under an oil microscope (Figure 2b). White colonies of varying sizes, dry or waxy colonies, with wrinkles and particles on the surface were observed after 3 days of aerobic incubation on a blood agar plate (containing blood components that provide ample nutrients and growth factors, suitable for the growth of most aerobic and facultative anaerobic bacteria) of alveolar lavage fluid (Figure 2c). MALDI-TOF MS was used for colony identification and it indicated Nocardia wallacei with a 99.9% confidence (Figure 2d).