The chest X-ray in this image is from an immune-compromised child who has a rather rare condition – Nocardiasis – which is acquired from pathogens in the soil, especially from organic rich soil. The spores are inhaled, and then multiply and grow in the lungs, being transported to other parts of the body. I particularly remember a man with huge liver abscesses due to this condition.
The diagnosis is difficult to make as it mimics many other conditions including tuberculosis.
I’ve tried to represent the colonies growing on a culture, and overlaid the Chest X-ray as though projected faintly onto the multiple white bacterial colonies.