Summary

• A localised or disseminated infection caused by the actinomycete Nocardia species.
• Typically occurs in immunocompromised patients with sub-acute or chronic pulmonary disease. More prevalent in patients with deficient cell-mediated immunity (e.g., post-transplant, with AIDS, on corticosteroid therapy, or with malignancies).
• Disseminated forms (lungs, skin, subcutaneous tissues, and CNS) frequently occur.
• Treatment of immunocompromised patients with disseminated or severe disease consists of intravenous therapy with 2 or more antibiotics.
• High tendency to recur. Maintenance therapy should be continued until the immunocompromised state can be reversed or improved.
• Surgical treatment may be needed in some cases (e.g., CNS abscesses with poor response to antimicrobial treatment).