SummaryWe report a case of acute pleuropulmonary nocardial infection in a 24-year-old woman suffering from systemic lupus erythematosus. In most instances,Nocardia asteroidesis an opportunistic pathogen. In our patient, the infection was facilitated by systemic lupus erythematosus and chronic use of corticosteroids and immunosuppressive drugs.N. asteroideswas cultured from both pleural effusion and blood. No extra thoracic location was found and the patient improved upon intravenous antibiotics and pleural drainage. Owing to the poor tolerance of trimethoprim/sulfamethoxazole, the patient was treated successfully with imipenem. The predisposing factors, the clues to the diagnosis and the therapy of nocardiosis are briefly reviewed.