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Pulmonary nocardiosis
Nocardiosis - pulmonary; Mycetoma; Nocardia
Pulmonary nocardiosis is an infection of the lung with the bacteria, Nocardia asteroides .
Causes
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.
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
People with a weak immune system are at a high risk for nocardia infection. This includes people who have:
- Been taking steroids or other medicines that weaken the immune system for a long time
- Cushing disease
- An organ transplant
-
HIV/AIDS
HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune ...
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Other people at risk include those with long-term (chronic) lung problems related to smoking, emphysema, or other tuberculosis .
Tuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
Symptoms
Pulmonary nocardiosis mainly affects the lungs. But, it can also spread to other organs in the body. Common symptoms may include:
ENTIRE BODY
-
Fever
(comes and goes)
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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General ill feeling (
malaise
)
Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
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GASTROINTESTINAL SYSTEM
- Nausea
-
Liver and spleen swelling (
hepatosplenomegaly
)
Hepatosplenomegaly
Hepatomegaly is swelling of the liver beyond its normal size. If both the liver and spleen are enlarged, it is called hepatosplenomegaly.
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- Vomiting
LUNGS AND AIRWAYS
- Breathing difficulty
- Chest pain not due to heart problems
- Coughing up blood or mucus
- Rapid breathing
-
Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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MUSCLES AND JOINTS
NERVOUS SYSTEM
- Change in mental state
- Confusion
- Dizziness
- Headache
- Seizures
SKIN
- Skin rashes or lumps
- Skin sores (abscesses)
-
Swollen lymph nodes
Swollen lymph nodes
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
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Exams and Tests
Your health care provider will examine you and listen to your lungs using a stethoscope. You may have abnormal lung sounds, called crackles. Tests that may be done include:
-
Bronchoalveolar lavage -- fluid is sent for stain and culture, which is taken by
bronchoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan
of the chest
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Pleural fluid culture
and stain
Pleural fluid culture
Pleural fluid culture is a test that examines a sample of fluid that has collected in the pleural space to see if you have an infection or understand...
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Treatment
The goal of treatment is to control the infection. Antibiotics are used, but it may take a while to get better. You're provider will tell you how long you need to take the medicines. This may be for up to a year.
Surgery may be needed to remove or drain infected areas.
Your provider may tell you to stop taking any medicines that weaken your immune system. Never stop taking any medicine before talking to your provider first.
Outlook (Prognosis)
The outcome is often good when the condition is diagnosed and treated quickly.
The outcome is poor when the infection:
- Spreads outside the lung
- Treatment is delayed
- The person has a serious disease that leads to or requires long-term suppression of the immune system
Possible Complications
Complications of pulmonary nocardiosis may include:
-
Brain abscesses
Brain abscesses
A brain abscess is a collection of pus, immune cells, and other material in the brain, usually from a bacterial or fungal infection.
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When to Contact a Medical Professional
Call your provider if you have symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome.
Prevention
Be careful when using corticosteroids. Use these drugs sparingly, in the lowest effective doses and for the shortest periods of time possible.
Some people with a weak immune system may need to take antibiotics for long periods of time to prevent the infection from returning.
References
Southwick FS. Nocardiosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 330.
Torres A, Menendez R, Wunderink RG. Bacterial pneumonia and lung abscess. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 33.
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 8/21/2016
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
