A case is reported in a 30-yr-old man from the Netherlands who was admitted to hospital after falling from scaffolding into some grit and inhaling some of it. Chest radiography showed foreign bodies in the lower right lobe and bronchoscopy revealed grit in the lower and upper bronchus of the right lung. Two stones were removed by irrigation of both lobes. The patient developed fever 4 d later and chest radiography demonstrated an infiltrate in the left lower lobe. Gram stain of sputum samples revealed Gram positive organisms and Nocardia otitidiscaviarum was cultured. Computed tomography scans showed complete consolidation of the left lung but there was no evidence of dissemination to the brain. Fever resolved after treatment with trimethoprim-sulfamethoxazole for 22 d and a slight regression of the pulmonary infiltrates was observed after 6 wk. Intravenous antibiotic therapy was then replaced by oral ciprofloxacin.