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Nocardia infection

Nocardiosis

 

Nocardia infection is a disorder that affects the lungs, brain, or skin. In otherwise healthy people, it may occur as a local infection. But in people with weakened immune systems, it may spread throughout the body.

Causes

 

Nocardia infection is an infection caused by a bacterium. It usually starts in the lungs. It may spread to other organs, most often the brain and the skin. It may also involve the kidneys, joints, heart, eyes, and bones.

Nocardia bacteria are found in soil around the world. You can get the disease by breathing in dust that has the bacteria. You can also get the disease if soil containing nocardia bacteria gets into an open wound.

You are more likely to get this infection if you have chronic lung disease or a weakened immune system, which can occur with transplants, cancer, HIV/AIDS, and long-term use of steroids.

 

Symptoms

 

Symptoms vary, and depend on the organs involved.

If in the lungs, symptoms may include:

  • Chest pain when breathing (may occur suddenly or slowly)
  • Coughing up blood
  • Fevers
  • Night sweats
  • Weight loss

If in the brain, symptoms may include:

  • Fever
  • Headache
  • Seizures
  • Coma

If the skin is affected, symptoms may include:

  • Skin breakdown and a draining tract (fistula)
  • Ulcers or nodules with infection sometimes spreading along lymph nodes

Some people with nocardia infection have no symptoms.

 

Exams and Tests

 

The health care provider will examine you and ask about your symptoms.

Nocardiosis is diagnosed using tests that identify the bacteria. For example, for an infection in the lung, a sputum culture may be done.

Depending on the part of the body infected, testing may involve taking a tissue sample by:

  • Brain biopsy
  • Lung biopsy
  • Skin biopsy

 

Treatment

 

You will need to take antibiotics for 6 months to a year or longer. You may need more than one antibiotic.

Surgery may be done to drain pus that has collected in the skin or tissues (abscess).

 

Outlook (Prognosis)

 

How well a person does depends on your overall health and the parts of the body involved. Infection that affects many areas of the body is hard to treat, and some people may not be able to recover.

 

Possible Complications

 

Complications of nocardial infections depend on how much of the body is involved.

  • Certain lung infections may lead to scarring and chronic shortness of breath.
  • Skin infections may lead to scarring or disfigurement.
  • Brain abscesses may lead to loss of neurological function.

 

When to Contact a Medical Professional

 

Call your provider if you have any symptoms of this infection. They are nonspecific symptoms that can have many other causes.

 

 

References

Sorrell TC, Mitchell DH, Iredell JR, Chen SC-A. Nocardia species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 255.

Southwick FS. Nocardiosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 330.

 
  • Antibodies

    Antibodies - illustration

    Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

    Antibodies

    illustration

    • Antibodies

      Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

    Talking to your MD

     

      Self Care

       

        Tests for Nocardia infection

         

           

          Review Date: 11/27/2016

          Reviewed By: Arnold Lentnek, MD, Infectious Diseases Medical Practice of NY and Clinical Research Centers of CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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