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).
Nocardiosis is a localised or disseminated infection caused by the actinomycete Nocardia species that usually affects immunocompromised patients. It has been reported more frequently in patients with deficient cell-mediated immunity, such as organ transplant recipients and AIDS patients. Clinical presentation can be acute, sub-acute, or, more frequently, chronic. Nocardiosis has a high mortality rate and a tendency to recur. Immunocompetent patients usually develop localised cutaneous lesions, cellulitis, abscesses, or sporotrichoid forms.
History and exam
Division of Infectious Disease
Geneva University Hospital
JG declares that he has no competing interests.
Division of Infectious Diseases
JA declares that he has no competing interests.
Infectious Disease Specialist
Alabama Infectious Diseases Center
AH declares that he has no competing interests.
Associate Professor of Medicine
Division of Pulmonary and Critical Care
Harborview Medical Center
University of Washington
MN declares that he has no competing interests.
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