case_images: PMC10858340_01
case_images: The chest X-ray showed left homogeneous opacity.
case_images: cureus-0016-00000052071-i01.jpg
case_images: PMC10858340_01_cureus-0016-00000052071-i01.jpg
case_images: FIG1
case_images: The chest X-ray showed left homogeneous opacity and consolidation suggestive of parapneumonic pleural effusion or empyema (Figure 1).
case_images: Gram stain of the pleural fluid showed gram-positive beaded branching filamentous bacilli.
case_images: cureus-0016-00000052071-i02.jpg
case_images: PMC10858340_01_cureus-0016-00000052071-i02.jpg
case_images: FIG2
case_images: On the gram stain, branching filamentous beaded gram-positive bacilli were seen (Figure 2).
case_images: Modified Ziehl-Neelsen stain (1% sulphuric acid (H2SO4)) of the pleural fluid, showing pink-colored branching acid-fast filamentous bacilli suggestive of Nocardia species.
case_images: cureus-0016-00000052071-i03.jpg
case_images: PMC10858340_01_cureus-0016-00000052071-i03.jpg
case_images: FIG3
case_images: Chalky white dry colonies on Sabouraud dextrose agar
case_images: cureus-0016-00000052071-i04.jpg
case_images: PMC10858340_01_cureus-0016-00000052071-i04.jpg
case_images: FIG4
case_images: Chalky white dry colonies on blood agar
case_images: cureus-0016-00000052071-i05.jpg
case_images: PMC10858340_01_cureus-0016-00000052071-i05.jpg
case_images: FIG5