During the autumn of 2017, a 69-year-old man suffering from edema in both lower legs was admitted to our hospital. He was diagnosed with NS (membranous nephropathy), and an intravenous methylprednisolone therapy (32 mg/d) was initiated. There was no improvement 1 month post-treatment, so the patient was started on a combination therapy of oral prednisone (25 mg/d) and hemodialysis. His renal disease stabilized, so the prednisone dosage was reduced to 15 mg/d as the maintenance therapy. After 2 months of combination therapy, the 24-h urinary protein loss was reduced to 378 mg/d, while the serum albumin level rose to 22.9 g/L. However, he developed low fever, cough, and chest pain. The laboratory examination showed elevated WBC count (11.8x109/L) with 91% neutrophils, CRP (26 mg/L), PCT (2.9 ng/ml), and ESR (90 mm/h). Serum beta-D-glucan and galactomannan were normal. Chest CT revealed bilateral inflammation, cavities in the right upper lobe, and multiple nodules in both lungs. Mycobacterium tuberculosis-specific T lymphocyte (T spot-TB) was positive, but M tuberculosis was not founded in the sputum. Based on the clinical features, imageological characteristics, and lab tests, the patient was administrated a combination of isoniazid and rifampin because M tuberculosis was suspected of etiological agent. Nevertheless, his symptoms did not improve, and the chest CT revealed enlarged nodules in the right middle lobe and aggravated inflammation in the left lower lobe. A firm abscess (2cmx1cm in diameter) which manifested as tender was founded in the left upper groin. Ultrasonography (USG) of the abscess showed thickened subcutaneous soft tissue and non-uniform internal echo ( Supplementary Figure S6 ). He had no history of trauma. The abscess was drained, and the yellowish purulent discharge was sent to the laboratory for culture. The Gram-and modified acid-fast staining of the sputum showed filamentous, beaded, branching bacilli which was suspected of Nocardia spp. ( Supplementary Figure S6 ). The sputum was resubmitted, cultured aerobically on the blood agar after digestion with 2% potassium hydroxide (KOH), and incubated at 37 C to confirm the presence of Nocardia spp. The pus and sputum culture presented yellowish Nocardia spp., identified as N.farcinica by gene sequencing ( Supplementary Figure S7 ). Pus and sputum cultures, and morphological evidence of sputum were positive for Nocardia spp. and disseminated nocardiosis was diagnosed. Antibiotic therapy was replaced with intravenous cefatriaxone (2 g/d) and oral TMP-SMX (0.96 g thrice daily) for 2 weeks. The patient was discharged as his clinical condition improved after 43 days of hospitalization. He continued oral TMP-SMX monotherapy for 6 months and remained in good condition. The treatment flow diagrams of the case are presented in  Supplementary Figure S8 .