Highlights & Basics
- Nocardiosis is a localized or disseminated infection caused by the actinomycete Nocardia.
- Typically occurs in immunocompromised patients, particularly those with deficient cell-mediated immunity (e.g., post-transplant, with AIDS, on corticosteroid therapy, or with malignancies).
- Disseminated forms (lungs, skin, subcutaneous tissues, and central nervous system [CNS]) may occur in some patients.
- Treatment of immunocompromised patients with disseminated or severe disease consists of intravenous therapy with two or more antibiotics.
- High tendency to recur. Maintenance therapy should be continued until the immunocompromised state can be reversed or improved.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Expectorated sputum specimen: modified acid-fast staining showing Nocardia species
Expectorated sputum specimen: Ziehl-Neelsen staining to compare the different morphology of Mycobacterium and Nocardia
Pulmonary nocardiosis: CT scan with nodular lesions in an immunosuppressed patient
Disseminated nocardiosis: CT scan with brain abscesses in an immunosuppressed patient
Citations
Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006 Apr;19(2):259-82.[Abstract][Full Text]
Hamdi AM, Fida M, Deml SM, et al. Retrospective analysis of antimicrobial susceptibility profiles of Nocardia species from a tertiary hospital and reference laboratory, 2011 to 2017. Antimicrob Agents Chemother. 2020 Feb 21;64(3):e01868-19.[Abstract][Full Text]
Corti ME, Villafane-Fioti MF. Nocardiosis: a review. Int J Infect Dis. 2003 Dec;7(4):243-50.[Abstract][Full Text]
Margalit I, Lebeaux D, Tishler O, et al. How do I manage nocardiosis? Clin Microbiol Infect. 2021 Apr;27(4):550-8.[Abstract][Full Text]
Restrepo A, Clark NM, Infectious Diseases Community of Practice of the American Society of Transplantation. Nocardia infections in solid organ transplantation: guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation. Clin Transplant. 2019 Sep;33(9):e13509.[Abstract]
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