Nocardiosis: Updates and Clinical Overview

Abstract

Nocardia, a gram-positive bacillus with the microscopic appearance of branching hyphae, can produce considerable disease in the appropriate host. The taxonomy of Nocardia continues to evolve; more than 50 species have been described. Early recognition and effective therapy are imperative to achieve successful outcomes. Although nocardiosis typically occurs in patients with cell-mediated immunosuppressive conditions, infection may occasionally develop in immunocompetent patients as well. This review addresses the microbiology of Nocardia, risk factors for infection, clinical presentations, and management strategies.

Fatal cases of disseminated nocardiosis: challenges to physicians and clinical microbiologists – Case report

“…Pulmonary nocardiosis is the most common clinical presentation of this infection, while among extrapulmonary forms, CNS involvement is quite common [1,5,6]. Bacteremia caused by Nocardia spp.…”

“…Bacteremia caused by Nocardia spp. is rarely described clinical entity, and in the majority of patients, concurrent pulmonary (64%), cutaneous (28%), and CNS involvements (19%) could be observed [6]. In the case of disseminated nocardiosis, two or more organs are infected, and in the majority of cases, due to airway transmission, the lung is also affected.…”

Nocardia transvalensis/wallacei hindfoot actinomycetoma

“…The deep infection has a chronic course, with granulomatous and fibrosing evolution, that leads to multiple sinus tracts formation, overlaid by hypertrophic verrucous skin. Later, progressive destruction of subcutaneous tissues, fascia, and muscles, causing deformation and functional impairment develops [7,8] . Soil is the likely reservoir; however no environmental source has been identified.…”

“…Pijper et al reported the first case of N. transvalensis infection in 1927 as a pathogen of foot mycetoma in a South African patient. It has since been reported in a range of other infections in Australia, Africa, North America, Europe and Thailand [8,14] with a few reported in Japan [15] and Saudi Arabia [16] .…”

Unexplained Pleural Infection in an Immunosuppressive Patient: Nocardiosis

“…Eğer allerji nedeniyle sulfon grubu verilemiyor ise kültürde ilaç direnç paternine göre alternatif bir seçim yapılmaktadır. Nüks eğilimi nedeniyle tedavinin 6-12 ay yapılması önerilmek-tedir (8). Hastamıza trimetoprim -sulfametaksazol tedavisi başlanmış ve birinci ay kontrolünde belirgin klinik ve radyolojik iyileşme gözlenmiştir.…”