{
  "abstract": "An immunocompetent male in his 30s with a history of bronchiectasis presented with recurrent haemoptysis (5–10 mL every 2 months) over 4 years. High-resolution CT revealed cystic bronchiectasis and ground-glass opacities. Bronchoscopy identified active bleeding from a ruptured bronchial artery, which was successfully managed with emergent embolisation. Bronchoalveolar lavage demonstrated weakly acid-fast branching filaments, later confirmed as Nocardia asteroides by matrix-assisted laser desorption-ionisation time of flight mass spectrometry. The patient responded well to trimethoprim-sulfamethoxazole and remained stable at follow-up.This case highlights three key points: (1) pulmonary nocardiosis should be considered in chronic haemoptysis, especially in patients with structural lung disease, even if immunocompetent; (2) rapid microbiological diagnosis is critical, particularly when acid-fast staining yields atypical results; and (3) bronchial artery embolisation can be lifesaving in cases of nocardial vasculitis with active bleeding. The report underscores the importance of multidisciplinary management in such complex presentations.",
  "authors": [
    {
      "affiliations": [
        "Respiratory Medicine, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"
      ],
      "name": "Amisha Harish Soni"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"
      ],
      "name": "Babaji Ghewade"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"
      ],
      "name": "Poonam Avinash Patil"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"
      ],
      "name": "Aarnav Mehta"
    }
  ],
  "title": "Pulmonary nocardiosis masquerading as refractory haemoptysis in a bronchiectasis patient: the critical role of multidisciplinary management",
  "uid": "df33d765-7e7d-574f-af1d-be2b1c77faee"
}