Nocardiosis is an infection caused by bacteria called Nocardia asteroides, as well as a variety of other Nocardia species. It usually starts in the lungs and may spread to the skin and brain.
The bacteria that causes nocardiosis, is found worldwide in the natural environment. The bacteria usually live in decaying matter in the soil. A person usually gets nocardiosis after inhaling the organisms in dust.
The bacteria can also enter a person's body through puncture wounds or abrasions of the skin which are contaminated by soil.
Nocardiosis begins as a lung infection. It can spread through the bloodstream to cause abscesses, or pockets of pus, in many parts of the body. Abscesses can develop in the brain, kidney, liver, bone, and beneath the skin
Nocardiosis often begins as a lung infection, such as pneumonia. The symptoms include: coughthick sputumshortness of breathchest painfeverchillsnight sweatsloss of appetitegeneral weaknessweight loss
When the infection involves the skin, there is a red bump or ulcer, and there may be swollen lymph glands. If the infection spreads to the brain, symptoms may include: confusiondisorientation, which means a loss of awareness of people, place, and timedizzinessheadachenauseaseizures
A Nocardium bacterium causes nocardiosis. Chronically ill people and those receiving medications that suppress the immune system are at increased risk for this condition. It is more common in men.
There is no known prevention for nocardiosis.
Nocardiosis is diagnosed when thebacteria is found in samples of body fluid or tissue taken from an infected person.
If untreated, nocardiosis can lead to fatal brain infections. The mortality rate for a person with nocardiosis brain infection is 80%.
Nocardiosis is not spread from person to person.
Treatment of nocardiosis includes the medication trimethoprim sulfamethoxazole (TMP/SMX, such as Bactrim, Cotrim, Septra). It must be taken for several months. If the person does not respond to TMP/SMX, other antibiotics can be added. These include ampicillin, erythromycin, and minocycline. The person may also need to have abscesses drained surgically.
Antibiotics may cause stomach upset, diarrhea, or an allergic reaction. Surgery can cause bleeding, infection, and allergic reactions to anesthesia.
Treatment of nocardiosis may need to be prolonged. The person needs to be aware of the importance of taking the antibiotic as prescribed, even after the symptoms have disappeared. It may take a long time for the person to feel better.
Frequent follow-up exams are very important. Blood tests may be used to monitor medication levels. Any new or worsening symptoms should be reported to the healthcare professional.
Professional Guide to Diseases, Springhouse Corporation, 1998
Current Medical Diagnosis and Treatment, Tierney, 2000
The Merck Manual of Medical Information, 1997
