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A 45-year-old man presented with persistent nasal discharge and later developed arthropathy, cutaneous vasculitis, a macular rash and radiographic lung opacities. Early relapse after starting immunosuppressive therapy consisted of new cavitating lung opacities, as seen in Wegener's granulomatosis, and subcutaneous nodules. Lymph node biopsy showed Nocardia asteroides. One month after high dose cotrimoxazole the chest X-ray was normal.
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