Nocardia
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Etiology
- associated conditions
Epidemiology
- saprophytic, found in soil
Pathology
Laboratory
- Nocardia serology
- Nocardia identified in isolate
- gram stain: gram-positive filamentous bacillus[3]
- weakly acid-fast staining positive
- aerobic, non-spore formings
- Nocardia identified by culture
- slow-growing in culture, 8 weeks
Diagnostic procedures
Radiology
- chest X-ray
- nodular densities in upper & lower lung field
Complications
- most common site of dissemination from the lungs is the CNS leading to focal neurologic deficits
- skin, bone & muscle are the next most common sites of dissemination
- pericarditis can occur
- endocarditis is rare - cardiac murmur, retinal hemorrhages, splenomegaly
Management
- sulfisoxazole
- Bactrim
- minocycline
- imipenem (synergism with cefotaxime)
- cefotaxime (synergism with imipenem)
- amikacin
* if symptoms recur after treatment (within months) consider pulmomary alveolar proteinosis
More general terms
More specific terms
Additional terms
- nocardiosis
- pulmonary alveolar phospholipoproteinosis; alveolar proteinosis; pulmonary surfactant metabolism dysfunction; inborn error of pulmonary surfactant metabolism
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 809
- ↑ ARUP Consult: Actinomyces and Nocardia Species deprecated reference
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 16, 18. American College of Physicians, Philadelphia 2012, 2018
- ↑ NEJM Knowledge+
Coussement J, Lebeaux D, Rouzaud C, Lortholary O. Nocardia infections in solid organ and hematopoietic stem cell transplant recipients. Curr Opin Infect Dis. 2017 Dec;30(6):545-551. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28922286 Review.
Martinez R, Reyes S, Menendez R. Pulmonary nocardiosis: risk factors, clinical features, diagnosis and prognosis. Curr Opin Pulm Med. 2008 May;14(3):219-27. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18427245 Review.