Nocardiosis: Risk Factors, Clinical Characteristics and Outcome

Abstract

Nocardiosis has been reported increasingly in recent two decades, probably due to improvement in isolation of the organism and increased burden of immune compromised patients. Nocardia occasionally has been reported in healthy people. A case series of definitive Nocardiosis (2002 to 2010), clinical characteristics, underlying diseases, immune status and in-patient outcome were studied in a tertiary referral center. Twenty one patients with definite diagnosis of Nocardiosis were studied. 17 cases (81%) had an underlying disease (diabetes mellitus, corticosteroid therapy, and chronic granulomatous disease and collagen vascular diseases). Four patients (19%) were immune-competent without any predisposing disease. In 17 patients (81%), Nocardiosis was limited to respiratory tract and in 4 cases (19%) it was disseminated with multi organ involvement. Two cases (9.5%) died in hospital.

A Case of Pulmonary Nocardiosis Due to Nocardia cyriacigeorgica

“…15 In an observational study of all the patients diagnosed with pulmonary Nocardiosis over a 13-year period the predisposing conditions were defined as; COPD (23%) transplantation(29%), HIV infection (19%), alcoholism (6.5%) and treatment with steroids (64.5%). 16 Early identification and therapy of Nocardiosis is important for mortality especially among immunocompromised patients.…”

Nocardial brain abscess in a patient with pulmonary alveolar proteinosis

“…Further, a diagnostic biopsy should always be performed in order to make smear microscopy and culture, which in our case showed the bacteria Nocardia asteroides . [ 3 7 ]…”

“…This decrease may be the result of an incomplete differentiation in macrophages, which increases susceptibility to infections such as nocardial infections. [ 7 8 ] Among the numerous suggested etiologies for PAP, such as lung infections and hematologic malignancies, studies have shown a correlation between PAP and a chronic exposure to silica dust. [ 9 ]…”

Pulmonary nocardiosis caused by Nocardia cyriacigeorgica in patients with Mycobacterium aviumcomplex lung disease: two case reports

“…Accumulating evidence suggests there are defined risk factors for Nocardia species infection: HIV infection [ 5 ], corticosteroid therapy or use of immunosuppressive agents [ 5 ],[ 6 ], organ transplantation [ 6 ], and diabetes mellitus [ 3 ]. Preexisting rheumatic disease treated with immunosuppressant therapy, as in Case 1, is another risk factor for Nocardia species infection [ 14 ].…”