Nocardia Infection:Nocardiosis, or infection by the Nocardia bacteria, primarily affects the lungs, brain, and skin, especially in individuals with weakened immune systems. Approximately 80% of nocardiosis cases involve lung infections, brain complications, or widespread disease. The other 20% are skin infections. For those with pulmonary nocardiosis, common symptoms include fever, coughing, and chest discomfort. Brain nocardiosis typically presents with headaches, confusion, seizures, and sudden neurological issues. Nocardia bacteria are commonly found in soil and dust. Inhalation of Nocardia spores often leads to lung infections, while skin infections occur when contaminated soil enters wounds. There is no evidence that Nocardia spreads from person to person.Nocardiosis outbreaks often occur in patients with weakened immune systems, such as those undergoing organ transplants, suffering from immune disorders, or taking high-dose steroids. Diagnosing Nocardia can be challenging, but newer molecular techniques aid in faster identification. Nocardia asteroides accounts for over half of invasive Nocardia infections, while other species like N. farcinica, N. nova, N. transvalensis, N. brasiliensis, and N. pseudobrasiliensis also cause disease.Treatment typically involves long-term antibiotic therapy, often lasting six months to a year, depending on the individual and infection site. Chronic suppressive therapy with low-dose antibiotics may be necessary, and surgical drainage might be required for abscesses. The preferred treatment is a combination of trimethoprim-sulfamethoxazole (TMP-SMX), though resistance is increasing. A new regimen combining sulfonamide, ceftriaxone, and amikacin shows promise for resistant infections. Approximately 10% of uncomplicated Nocardia cases result in fatalities, with higher rates in severe infections, widespread disease, and brain abscesses.
