Tuberc Respir Dis.  2014 Dec;77(6):271-273. 10.4046/trd.2014.77.6.271.

Systemic Nocardiosis Mimicking Disease Flare-up after Discontinuation of Gefitinib in a Patient with EGFR-Mutant Lung Cancer

  • 1Department of Internal Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea.
  • 2Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea.


Disease flare-up after discontinuing epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) has been considered as a critical issue in lung cancer patients who have experienced radiologic progression after showing initial durable response. This is a case of systemic nocardiosis that occurred after chronic steroid use for radionecrosis from stereotactic radiosurgery. It was initially thought as a disease flare-up after stopping EGFR-TKI.


EGFR Tyrosine Kinase Inhibitor 324674; Nocardia Infections; Carcinoma, Non-Small-Cell Lung; Radiosurgery

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Lung Neoplasms*
Nocardia Infections*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor


  • Figure 1 Serial radiologic evaluation including chest X-ray scans (A) and brain magnetic resonance imaging (B, C). TMP-SMX: trimethoprim-sulfamethoxazole.


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