This paper highlights an uncommon complication of a percutaneous transthoracic needle biopsy (PTNB). A patient with rheumatoid arthritis who was on immune suppressive drugs underwent a PTNB of a lung nodule. The histology showed “organizing usual interstitial pneumonia-like changes.” Unfortunately, one month after the PTNB, she developed a large deep-seated chest wall abscess at the biopsy needle tract and the previously seen lung nodule was larger. Nocardiosis sp. was isolated from the chest wall abscess. The lung and chest wall lesions were resolved with Bactrium and Fluconazole. The final diagnosis was pulmonary nocardiasis complicated by chest wall seeding following the PTNB procedure.