Pulmonary nocardiosis

Alternative Names: Nocardiosis - pulmonary

Pulmonary nocardiosis is an infection of the lung with the bacteria, Nocardia asteroides.

Causes of Pulmonary nocardiosis

Nocardia infection develops when you breathe in (inhale) the bacteria. The infection causes pneumonia -like symptoms. The infection can spread to any part of the body.

People at highest risk for nocardia infection are those with a weakened immune system. This includes people who have:

• Been taking steroid medicines or other medicine that weaken the immune system for a long time
• Had an organ transplant
• HIV

Other people at risk include those with chronic lung problems related to smoking, emphysema, or other infections such as tuberculosis.

Pulmonary nocardiosis Symptoms

• Entire body
  • Fever (comes and goes)
  • General ill feeling (malaise)
  • Night sweats
• Gastrointestinal system
  • Nausea
  • Liver and spleen swelling (hepatosplenomegaly)
  • Unintentional weight loss
  • Vomiting
• Lungs and airways
  • Breathing difficulty
  • Chest pain not due to heart problems
  • Coughing up blood
  • Cough with mucus
  • Rapid breathing
  • Shortness of breath
• Muscles and joints
  • Joint pain
• Nervous system
  • Change in mental state
  • Confusion
  • Dizziness
  • Headache
  • Seizures
• Skin
  • Skin rashes or lumps
  • Skin sores (abscesses)
  • Swollen lymph nodes

Tests and Exams

• Bronchial alveolar lavage - fluid is sent for stain and culture
• Bronchoscopy
• Chest x-ray
• Crackles (rales) in the infected lung detected by stethoscope
• CT scan
• Decreased breath sounds in the lung
• Pleural fluid culture and stain
• Sputum stain and culture

Treatment of Pulmonary nocardiosis

The goal of treatment is to control the infection. Antibiotics are used, but the response to treatment may be slow and you must keep taking the medications for at least 3 months.

Surgery may be needed to remove or drain infected areas.

Prognosis (Outlook)

The outcome is often good when diagnosed and treated quickly.,

The outcome is poor when the infection spreads outside the lung, treatment is delayed, or the patient has serious underlying diseases.

Potential Complications

• Brain abscesses
• Skin infections

When to Contact a Health Professional

Call your health care provider if you have symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome.

Prevention of Pulmonary nocardiosis

Be careful when using corticosteroids. Use these drugs sparingly, in the lowest effective doses and for the shortest periods of time possible.

Some patients with an impaired immune system may need to take antibiotics for long periods of time to prevent the infection from returning.

Torres A. Pyogenic Bacterial Pneumonia and Lung Abscess. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.

Respiratory system

Review Date: 9/17/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

_{Do not use this information for medical emergencies - Call 911. This information should not be used for the diagnosis or treatment of any medical condition. A licensed medical practitioner should always be consulted for diagnosis and treatment of any and all medical conditions. Links to other websites do not constitute endorsements and are provided for information only. Any duplication or distribution of this information is strictly prohibited.
Copyright 2011 A.D.A.M., Inc.}