A 29-year-old liver transplant patient presents with fever, anorexia, night sweats, weight loss, and a productive cough for 1 week. His purified protein derivative (PPD) is 3 mm and his chest x-ray (CXR) shows a right upper lobe cavitation. Sputum examination shows acid-fast branching rods. What is the most likely diagnosis?
Answer: Nocardia. Remember to keep Nocardia in the differential for a cavitary lung lesion in an immunocompromised patient.
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