Summary
Definition
História e exame físico
Principais fatores diagnósticos
- cough with purulent sputum
- fever
Outros fatores diagnósticos
- headache
- nausea and vomiting
- confusion
- depressed consciousness
- cutaneous ulcers or abscesses
Fatores de risco
- solid organ and hematopoietic stem cell transplant recipients
- HIV-positive and low CD4 T-cell count (<100 cells/mm³)
- immunosuppression
- structural pulmonary disease
- malignancy and chemotherapy
- agricultural work
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Gram and acid-fast stains
- culture
- matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)
- biochemical species typing
- polymerase chain reaction (PCR)-based techniques
- chest x-ray
- CT head
Investigações a serem consideradas
- thoracic CT scan
- MRI head
Novos exames
- next-generation sequencing
Algoritmo de tratamento
severe nocardiosis: disseminated disease, CNS involvement, cavitary pulmonary lesions, or immunocompromise
nonsevere nocardiosis: immunocompetent, nondisseminated, no CNS involvement, no pulmonary cavitary lesions
Colaboradores
Autores
Timothy Sullivan, MD
Associate Professor
Division of Infectious Diseases
Icahn School of Medicine at Mount Sinai
New York
NY
Declarações
TS declares that he has no competing interests.
Agradecimentos
Dr Timothy Sullivan would like to gratefully acknowledge Dr Jorge Garbino and Dr Juan Ambrosioni, previous contributors to this topic.
Declarações
JG declares that he has no competing interests. JA is an advisory board member of Gilead Sciences and ViiV Healthcare.
Revisores
Senu Apewokin, MD
Associate Professor of Medicine
Director, Transplant Infectious Diseases
University of Cincinnati
Cincinnati
OH
Declarações
SA declares that she has no competing interests.
Rebecca N. Kumar, MD, MS
Assistant Professor of Medicine
Georgetown University Medical Center
Washington
DC
Declarações
RNK has received research grants from Regeneron and Gilead, which have been paid to Georgetown University.
Diagnósticos diferenciais
- Tuberculosis
- Actinomycosis
- Lung abscess
Mais Diagnósticos diferenciaisDiretrizes
- Nocardia infections in solid organ transplantation
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