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glossary:nocardia

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glossary:nocardia [2012/10/16 14:40] (current)
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 +Also called nocardiosis,​ [[infection]] with [[bacteria]] called Nocardia which tend to strike the [[lung]]s, brain and skin, particularly in people with an impaired immune system. The majority (about 80%) of cases of nocardiosis involves lung infection, brain [[abscess]],​ or disseminated (widespread) [[disease]] from Nocardia. The remaining 20% of cases are localized to the skin and cause cellulitis (skin infection).
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 +The most common symptoms with the pulmonary form of nocardiosis are fever, cough, and chest pain. With brain nocardiosis,​ the symptoms are usually headache, lethargy, confusion, seizures, and sudden onset of neurologic problems.
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 +Nocardia is ubiquitous in the environment. It is in the soil and in dust particles. The inhalation of Nocardia spores usually initiates pulmonary nocardiosis. The [[skin]] form of nocardiosis is contracted through soil contamination of wounds. There is no evidence for person-to-person transmission of Nocardia. ​
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 +Outbreaks of nocardiosis can occur in immunocompromised patients, including persons with [[malignancy]],​ [[connective tissue]] disorders, [[bone marrow]] transplantation or solid organ transplantation,​ high-dose corticosteroid use, and HIV/AIDS.
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 +The diagnosis of Nocardia may be difficult. Newer molecular diagnostic and subtyping methods can assist in earlier diagnosis. Nocardia asteroides is responsible for at least 50% of invasive Nocardia infections. Other species of Nocardia that may cause disease include N. farcinica, N. nova, N.transvalensis,​ N. brasiliensis,​ and N. pseudobrasiliensis.
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 +Long-term [[antibiotic]] therapy (usually with sulfonamides) may be given for 6 months to a year or longer depending on the individual and site involved. Frequently, chronic suppressive therapy may be needed with prolonged, low-dose antibiotic therapy. In addition, patients with abscesses may need [[surgery]] to ensure adequate drainage. ​
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 +The antimicrobial combination of trimethoprim-sulfamethoxazole (TMP-SMX) is the drug of choice for nocardiosis. However, resistance to TMP-SMX is becoming more common. A new combination drug therapy (sulfonamide,​ ceftriaxone,​ and amikacin) has shown promise for infections difficult to treat with TMP-SMX.
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 +About 10% of cases of uncomplicated Nocardia pneumonia are fatal. The fatality rates increase with overwhelming infection, disseminated disease, and brain abscess.
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glossary/nocardia.txt ยท Last modified: 2012/10/16 14:40 (external edit)