Nocardiosis is an infectious disease which affects the lungs or the whole body. Affectation of the lungs is termed as Pulmonary Nocardiosis while affectation of the entire body is referred to as Systemic Nocardiosis. Nocardiosis is caused primarily of an infection by bacterium of the genus Nocardia. The common forms are Nocardia asteroides and Nocardia brasiliensis. Men are more commonly affected particularly those whose immune systems are already compromised. Among patients afflicted with brain infection, rate of mortality goes beyond 80%. Among the other forms, mortality rate is at 50% even with therapy.

Routine cultures and chest X-rays are usually done.

Six months of treatment is important. Combination drug therapy (sulfonamide, ceftriaxone and amikacin) shows positive results. Bed rest is required for severe cases and surgery to remove necrotic tissue and drainage of abscesses.

Pulmonary infections include night sweats, cough, chest pain and fever. Neurological infections include headache, confusion, lethargy, sudden neurological deficits and seizures. Cerebral abscesses can be found in the CT-Scan. Lymphocutaneous disease manifests as nocardial cellulitis, nodular lymphangeitis with nodules alongside lymphatic pathway and rarely, mycetoma. Ocular diseases are rarely manifested. History of ocular trauma may be a finding. Disseminated nocardiosis manifests as disseminated infection among immunocompromised individuals. Involvement of the brain and lungs is observed. Moderate to high fever is also common. Cerebral abscesses and skin lesions may be apparent and severe pulmonary problems.

The organisms that cause this condition are usually found in the soil. They sometimes cause sporadic disease among people and animals from different parts of the world. Oftentimes transmission is via inhalation of organisms suspended in dust. Direct transmission through open wounds is uncommon. In general, a certain degree of immune suppression is a requirement of nocardial infection.

nocardiosis