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Nocardiosis

John P Barrett, MD, MPH, MS Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A rare infectious disease caused by Nocardia spp. bacteria located in ground and water sources

  • No pathognomonic presentation

  • Nocardiosis can be acute, subacute, or chronic, and involve...

DIAGNOSIS

HISTORY

  • Diagnosis requires a high index of clinical suspicion.

  • Symptoms vary by site of infection. Pulmonary, CNS, and cutaneous systems are most frequently infected:

    • Headache, anorexia, weight...

TREATMENT

GENERAL MEASURES

  • Consider infectious disease consultation.

  • Modify treatment based on sensitivity results.

MEDICATION

First Line

  • CNS/disseminated nocardiosis (3)[B],(4)[B],(5)[B],(2)[B]

    • Trimethopr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Recovery after a variable period of convalescence; activity may be increased as patients improve. 

Patient Monitoring

Patients on high-dose sulfonamide therapy shou...

REFERENCES

1
Nocardiosis. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP...

ADDITIONAL READING

Kamboj M, Winnicka L, Kamboj S, et al. Nocardiosis: the great imitator. Chest. 2017;152(4):A108.  

CODES

ICD10

  • A43.9 Nocardiosis, unspecified

  • A43.0 Pulmonary nocardiosis

  • A43.1 Cutaneous nocardiosis

  • A43.8 Other forms of nocardiosis

SNOMED

  • 29227009 Nocardiosis (disorder)

  • 2087000 Pulmonary nocardiosis (disor...

CLINICAL PEARLS

  • The diagnosis of nocardiosis requires a high degree of clinical suspicion.

  • Immunocompromised patients have more severe manifestations of disease.

  • Nocardiosis can progress and relapse des...

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