What is the definition of Nocardiosis?
Nocardiosis is a rare infectious disorder, that affects the brain, skin, and/or lungs. It occurs mainly in people with a weakened immune system but can affect anyone, and about one-third of infected people do not have any immune problems.. This condition usually starts in the lungs and can spread to other body organs. Affected individuals usually experience problems with their lungs (chest pain, coughing up blood, fevers), brain (headaches and seizures), and skin (skin infections, ulcers, and abscesses). Nocardiosis is caused by a bacteria of the family (genus) known as Nocardia which have different species (types). Nocardia bacteria are able to cause localized or systemic disease in humans and animals. The Nocordia bacteria are able to spread to any organ, specially the central nervous system (brain and spine), and have a tendency to recur or progress despite appropriate treatment. The nocardia bacteria are found in soil around the world. People contract this disease by either inhaling contaminated dust or if soil containing nocardia bacteria get into an open wound. People with nocardiosis may need to take multiple antibiotics given for several months—or even up to a year or more.
What are the alternative names for Nocardiosis?
- Nocardia infection
- Lung nocardiosis
What are the current treatments for Nocardiosis?
Nocardiosis is typically treated with the use of antibiotics. Because some Nocardia species are resistant to certain antibiotics, laboratory testing is needed to find out which species is causing the infection and to which antibiotic these bacteria may be susceptible. Treatment usually lasts for at least six months and may involve use of more than one antibiotic, but depending on the severity may last for about a year. Some abscesses or wound infections may need to be surgically drained.
The antibiotic known as trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the therapy of choice by most doctors. Other antibiotics include:
- Carbapenems (imipenem or meropenem, but not ertapenem)
- Third-generation cephalosporins (cefotaxime or ceftriaxone), and amikacin, alone or in combination.
- Imipenem plus amikacin (which may be the chosen treatment for patients with sulfonamide-allergic patients)
- Combination therapy with several antibiotics
Other alternative oral treatment include minocycline and amoxicillin/clavulanate, in addition to linezolid.