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Nocardiosis

Updated : February 29, 2024





Background

The disease nocardiosis affects many body organs. Nocardia, gram-positive bacilli with branched hyphae morphological features that may be found in decaying vegetation, soil, as well as other organic material, is the infectious illness that is responsible for it. Saltwater and freshwater both contain it.

Nocardia typically exhibits weak acid-fast positivity with staining under the microscope. Nocardia typically affects immunocompromised individuals as such an opportunistic pathogen that can affect practically every region of the body, including the pulmonary or pleural system, the skin, and other skin tissues, and it can spread widely and affect various organ systems.

Epidemiology

In the U.s, nocardiosis infections occur between 500 to 1000 instances each year on average. Although there is no race preference, it’s been noted that males have a 3:1 higher frequency of illness than females. Although there is no specific age range for disease, persons affected are often in their forties.

Anatomy

Pathophysiology

Nocardia is a widespread saprophyte that can be found in soil, water, and decomposing organic waste. Only 12 of the 100 recognized subtypes have been found to be disease-causing in people. On a microscope, Nocardia exhibits the usual filamentous, branching appearance, and beading.

The cutaneous illness typically develops following a localized skin injury. The cutaneous condition is not harmful in healthy people, but it has the ability to transmit to other systems in immunosuppressed patients.

Ulcers and the formation of abscesses are two possible symptoms of localized illness. Once contaminated airborne droplets are inhaled, pleuropulmonary nocardiosis develops. Patients who acquire lung illness typically have impaired immune systems (immunocompromised patients).

Etiology

Opportunistic illnesses, such as disseminated types of the disease, and pulmonary nocardiosis, primarily affect patients with impaired T cell-mediated immune function.

Patients with hematopoietic stem cell transplant receivers and organ transplants, HIV-positive sufferers, administering corticosteroids persistently, and people with active malignant procedures are those who are most susceptible to this.

Immunocompetent individuals who have had a straight inoculation of the bacterium into the cutaneous structures as a result of a traumatic incident are susceptible to developing primary cutaneous nocardiosis.

This is most frequently observed in those who work in rural areas and are involved in agricultural operations. Even though they are uncommon, using non-sterile instruments can result in postoperative wound infections.

Aerosolized injection of the bacterium into the airways causes pulmonary types of nocardiosis. Either of these first vaccinations may result in the dissemination of nocardiosis throughout the body.

There are several contributors to the development of Nocardia, including:

  • Alcohol addiction
  • Persistent lung disease (particularly those who have lungs alveoli proteins)
  • Transplant of a solid organ
  • Corticosteroid use
  • Hematological cancer
  • Lupus – Vascular collagen disease
  • Kidney failure
  • Colitis of the bowels
  • Whipple condition
  • Human immunodeficiency virus

Genetics

Prognostic Factors

Nocardiosis has various prognoses. It relies on the affected organ, how long it lasts, how well the person’s immune system is functioning, and how severe the infection is.

When given the proper care, skin and soft tissue have a far better prognosis than systemic disseminated and pleuropulmonary nocardiosis conditions.

Cutaneous nocardiosis can be treated in a number of people with appropriate therapy. However, less than sixty percent of people with brain abscesses recover.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

sulfisoxazole 

Oral administration of 2 g every 4 to 6 hours for at least six months
Immunocompromised patients require up to 1 year of this treatment



Dose Adjustments

Not Available

 
 

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK526075/

Nocardiosis

Updated : February 29, 2024




The disease nocardiosis affects many body organs. Nocardia, gram-positive bacilli with branched hyphae morphological features that may be found in decaying vegetation, soil, as well as other organic material, is the infectious illness that is responsible for it. Saltwater and freshwater both contain it.

Nocardia typically exhibits weak acid-fast positivity with staining under the microscope. Nocardia typically affects immunocompromised individuals as such an opportunistic pathogen that can affect practically every region of the body, including the pulmonary or pleural system, the skin, and other skin tissues, and it can spread widely and affect various organ systems.

In the U.s, nocardiosis infections occur between 500 to 1000 instances each year on average. Although there is no race preference, it’s been noted that males have a 3:1 higher frequency of illness than females. Although there is no specific age range for disease, persons affected are often in their forties.

Nocardia is a widespread saprophyte that can be found in soil, water, and decomposing organic waste. Only 12 of the 100 recognized subtypes have been found to be disease-causing in people. On a microscope, Nocardia exhibits the usual filamentous, branching appearance, and beading.

The cutaneous illness typically develops following a localized skin injury. The cutaneous condition is not harmful in healthy people, but it has the ability to transmit to other systems in immunosuppressed patients.

Ulcers and the formation of abscesses are two possible symptoms of localized illness. Once contaminated airborne droplets are inhaled, pleuropulmonary nocardiosis develops. Patients who acquire lung illness typically have impaired immune systems (immunocompromised patients).

Opportunistic illnesses, such as disseminated types of the disease, and pulmonary nocardiosis, primarily affect patients with impaired T cell-mediated immune function.

Patients with hematopoietic stem cell transplant receivers and organ transplants, HIV-positive sufferers, administering corticosteroids persistently, and people with active malignant procedures are those who are most susceptible to this.

Immunocompetent individuals who have had a straight inoculation of the bacterium into the cutaneous structures as a result of a traumatic incident are susceptible to developing primary cutaneous nocardiosis.

This is most frequently observed in those who work in rural areas and are involved in agricultural operations. Even though they are uncommon, using non-sterile instruments can result in postoperative wound infections.

Aerosolized injection of the bacterium into the airways causes pulmonary types of nocardiosis. Either of these first vaccinations may result in the dissemination of nocardiosis throughout the body.

There are several contributors to the development of Nocardia, including:

  • Alcohol addiction
  • Persistent lung disease (particularly those who have lungs alveoli proteins)
  • Transplant of a solid organ
  • Corticosteroid use
  • Hematological cancer
  • Lupus – Vascular collagen disease
  • Kidney failure
  • Colitis of the bowels
  • Whipple condition
  • Human immunodeficiency virus

Nocardiosis has various prognoses. It relies on the affected organ, how long it lasts, how well the person’s immune system is functioning, and how severe the infection is.

When given the proper care, skin and soft tissue have a far better prognosis than systemic disseminated and pleuropulmonary nocardiosis conditions.

Cutaneous nocardiosis can be treated in a number of people with appropriate therapy. However, less than sixty percent of people with brain abscesses recover.

sulfisoxazole 

Oral administration of 2 g every 4 to 6 hours for at least six months
Immunocompromised patients require up to 1 year of this treatment



Dose Adjustments

Not Available

https://www.ncbi.nlm.nih.gov/books/NBK526075/