Nocardia infection is a rare disorder affecting the lungs, brain, or skin. It occurs mainly in people with weakened immune systems.
Alternative NamesNocardiosis
Causes, incidence, and risk factorsNocardia infection is a bacterial infection that usually starts in the lungs. It then tends to spread to other organ systems -- most often the brain and the skin. It may also involve the kidneys, the joints, the heart, the eyes, and the bones.
Nocardia bacteria are found in soil around the world. You can get the disease by inhaling contaminated dust or if soil containing nocardia bacteria gets into an open wound.
While individuals with normal immune systems can get this infection, the main risk factors for getting nocardiosis are a weakened immune system or chronic lung disease. People on long-term steroid therapy, those with cancer, organ or bone marrow transplants, or HIV/AIDS are at risk.
SymptomsSymptoms vary and depend on the organs involved.
Some people with nocardia infection have no symptoms.
Signs and testsNocardia infection should be suspected in people with lung, brain, or skin symptoms if they also have a condition or conditions that weaken the immune system.
Nocardiosis is diagnosed using tests that identify the bacteria. Depending on the part of the body infected, testing may involve taking a tissue sample by:
Long-term antibiotic therapy (usually with sulfonamides) for 6 months to a year (or longer depending on the individual and the parts of the body involved) is needed to treat nocardia. Frequently, chronic suppressive therapy (long-term, low-dose antibiotic therapy) is needed.
In addition, patients who develop abscesses caused by this infection may need surgery to completely drain the abscesses.
Expectations (prognosis)How well a person does depends on the parts if the body involved. There is a significant Death Rate if more than one site is involved (disseminated nocardiosis). In addition, an individual's immune system plays a large role in how well they will do.
ComplicationsComplications of nocardial infections vary depending on what parts of the body are 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.
Calling your health care providerNotify your medical provider if you have any of the symptoms described above. These are non-specific symptoms that can have many causes other than nocardial infections. If you have lung, skin, or brain symptoms -- particularly if you have a weakened immune system -- tell your doctor. You will need to be evaluated for several potential infections, including nocardia.
ReferencesSorrell TC, Mitchell DH, Iredell JR. Nocardia species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 252.
Southwick FS. Nocardiosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 351.
Nocardia infection is a rare disorder affecting the lungs, brain, or skin. It occurs mainly in people with weakened immune systems.
Alternative NamesNocardiosis
Causes, incidence, and risk factorsNocardia infection is a bacterial infection that usually starts in the lungs. It may spread to other organ systems -- 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 inhaling contaminated dust or if soil containing nocardia bacteria gets into an open wound.
While individuals with normal immune systems can get this infection, the main risk factors for getting nocardiosis are a weakened immune system or chronic lung disease. People on long-term steroid therapy, those with cancer, organ or bone marrow transplants, or HIV/AIDS are at higher risk.
SymptomsSymptoms vary and depend on the organs involved.
Some people with nocardia infection have no symptoms.
Signs and testsNocardia infection should be suspected in people with lung, brain, or skin symptoms if they also have a condition or conditions that weaken the immune system.
Nocardiosis is diagnosed using tests that identify the bacteria. Depending on the part of the body infected, testing may involve taking a tissue sample by:
Long-term antibiotic therapy (usually with sulfonamides) for 6 months to a year (or longer depending on the individual and the parts of the body involved) is needed to treat nocardia. Frequently, chronic suppressive therapy (long-term, low-dose antibiotic therapy) is needed.
In addition, patients who develop abscesses caused by this infection may need surgery to completely drain the abscesses.
Expectations (prognosis)How well a person does depends on the parts if the body involved. There is a significant death rate if more than one site is involved (disseminated nocardiosis). In addition, an individual's immune system plays a large role in how well they will do.
ComplicationsComplications of nocardial infections vary depending on what parts of the body are 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.
Calling your health care providerNotify your medical provider if you have any of the symptoms described above. These are non-specific symptoms that can have many causes other than nocardial infections. If you have lung, skin, or brain symptoms -- particularly if you have a weakened immune system -- tell your doctor. You will need to be evaluated for several potential infections, including nocardia.
ReferencesSorrell TC, Mitchell DH, Iredell JR. Nocardia species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 252.
Southwick FS. Nocardiosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 351.
Reviewed ByReview Date: 09/15/2010
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Yes
Yes.
Nocardia species typically exhibit filamentous, branching growth patterns similar to fungal hyphae. They form a branching network of mycelium that can be seen under the microscope. However, unlike true fungi, Nocardia are classified as actinomycetes, which are a group of bacteria that share some characteristics with fungi.
mycobacterium
NocardioformsNocardioforms include nine genera of aerobic, acid-fast rods, including members of the genus Nocardia. Nocardioforms have aerial hyphae which project above the surface of their growth medium as branching filaments. The hyphae fragment into rods and cocci. Nocardioforms are found throughout nature in many types of soil and aquatic environments. One species, N. asteroides, causes infection of the human lung.
There are many different types of parasitic bacteria in the world. Some of these include Brucella, Legionella, Mycobacterium, and Nocardia.
b. predominance of unique, waxy, lipids
Enterobacter aerogenes is a non-acid fast bacteria. Bacteria only in the Mycobacteria and Nocardia genus are acid fast.
Nocardiosis is caused by a bacterium of the Nocardia species--usually N. asteroides, an organism that is normally found in the soil. The incubation period is not known, but is probably several weeks.
I think that there are two possible answers....first, Nocardia and, also, Bacillus anthracis. Lactobacillus might also work; however it is a microaerophilic organism and can only tolerate lesser levels of oxygen than a true aerobic organism. But all three are gram positive and, I believe, thrive with both dextrose and citrate. Nocardia has a Trycarboxylic acid cycle which utilizes both dextrose and citrate.
All cocci are gram (+) except Neisseria, Branhamella, Moraxella and Veilonella. All bacilli are gram (-) except Mycobacterium, Corynebacterium, Lactobacillus, Listeria, Clostridium, Bacillus, Erysipelothrix, and Nocardia. All spirals are gram (-)
Nocardia is not easily identified from cultures of sputum or discharge. A doctor can diagnose the condition using special staining techniques and taking a thorough medical history. Lung biopsies or x rays also may be required.