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Nocardiosis

 Nocardiosis


OVERVIEW

What Is Nocardiosis?

Nocardiosis is a rare infection caused by the Nocardia asteroides bacterium. This type of bacteria can be found in the soil and water of regions around the world. People may become infected with this bacteria when they inhale it or when the bacteria enter an open wound. The infection can’t be spread from one person to another.

Nocardiosis most commonly occurs in the lungs, but it may spread to other areas of the body, such as the:

*skin

*digestive system

*brain

*kidneys

*heart

*eyes

*bones

Though nocardiosis can develop in anyone, the condition is much more likely to affect people with very weak immune systems. An immune system may become compromised as a result of:

*cancer

*diabetes

*lung disease

*HIV

*AIDS

*a bone marrow or organ transplant

*the long-term use of steroid medications

In the United States, it’s estimated that 500 to 1,000Trusted Source cases of nocardiosis occur each year. In about 60 percent of these cases, the infection is related to a weak immune system.

Since a Nocardia infection is usually slow to respond to treatment, it can be life-threatening for those with weakened immune systems, especially if diagnosis and treatment are delayed. It’s important to seek treatment as soon as symptoms develop. This can help prevent the infection from spreading and causing complications.

SYMPTOMS

What Are the Symptoms of Nocardiosis?

The symptoms will vary depending on the area of the body that has become infected.

The Lungs

Nocardiosis most commonly affects the lungs. If your lungs are infected, you may experience:

*a fever

*fatigue

*chest pain

*a cough

*night sweats

*The Skin

The skin is the second most commonly affected area. If your skin becomes infected with Nocardia bacteria, you may experience:

*open, seeping sores

*ulcers

*rashes

*swollen lymph nodes

Other Areas

In some cases, the infection can spread to other parts of the body and cause varying symptoms.

If the infection spreads to your digestive system, you may experience:

*nausea

*vomiting

*sudden weight loss

*abdominal swelling

If the infection spreads to your brain, you may experience:

*seizures

*headaches

*confusion

*dizziness

DIAGNOSIS

How Is Nocardiosis Diagnosed?

Your doctor can diagnose this infection by performing various tests that check for the presence of N. asteroides bacteria. These tests may include the following:

*A chest X-ray is an imaging test that produces detailed images of the lungs.

*A bronchoscopy is a test in which your doctor uses a thin tube with an attached camera to view the lungs.

*A brain biopsy is a procedure that involves removing a small sample of abnormal brain tissue.

*A lung biopsy is a procedure that involves removing a small sample of abnormal lung tissue.

*A skin biopsy is a procedure that involves removing a small sample of abnormal skin cells.

*A sputum culture is a procedure that involves taking a small sample of mucus.

Causes

Normally found in soil, these organisms cause occasional sporadic disease in humans and animals throughout the world. Another well publicized find is that of Nocardia as part of the oral microflora. Nocardia spp. have been reported in the normal gingivae and periodontal pockets along with other species such as Actinomyces, Arthromyces and Streptomyces spp.

The usual mode of transmission is inhalation of organisms suspended in dust. Another very common method is by traumatic introduction, especially in the jaw. This leads to the entrance of Nocardia into the blood stream and the propagation of its pathogenic effects. Transmission by direct inoculation through puncture wounds or abrasions is less common.Generally, nocardial infection requires some degree of immune suppression.

A weakened immune system is a general indicator of a person who is more susceptible to nocardiosis, such as someone who already has a disease that weakens their immune system. Additionally, those with low T-cell counts or other complications involving T-cells can expect to have a higher chance of becoming infected. Besides those with weak immune systems, a local traumatic inoculation can cause nocardiosis, specifically the cutaneous, lymphocutaneous, and subcutaneous forms of the disease. There is no racial pattern in the risk of becoming infected with Nocardiosis.

Treatment

Nocardiosis requires at least 6 months of treatment, preferably with trimethoprim/sulfamethoxazole or high doses of sulfonamides. In patients who do not respond to sulfonamide treatment, other drugs, such as ampicillin, erythromycin, or minocycline, may be added.

Treatment also includes surgical drainage of abscesses and excision of necrotic tissue. The acute phase requires complete bed rest; as the patient improves, activity can increase.

A new combination drug therapy (sulfonamide, ceftriaxone, and amikacin) has also shown promise

TYPE OF DOCTOR AND DEPARTMENT: General Physician SPECIALIST CAN DIAGNOSES THIS DISEASE.

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