National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Nocardiosis


Other Names:
Nocardia infection; Lung nocardiosis
Categories:
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.[1][2][3]. 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).[1] 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.[3][4][5] 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.[1] People with nocardiosis may need to take multiple antibiotics given for several months—or even up to a year or more.[2][3] 
Last updated: 9/6/2017
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.[1][2][5]

The antibiotic known as trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the therapy of choice by most doctors. Other antibiotics include:[2][3][5]
  • Sulfonamides
  • 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)
  • Linezolid
  • Tigecycline
  • Combination therapy with several antibiotics
Other alternative oral treatment include minocycline and amoxicillin/clavulanate, in addition to linezolid.[5] 
Last updated: 3/24/2017

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • You can obtain information on this topic from the Centers for Disease Control and Prevention (CDC). The CDC is recognized as the lead federal agency for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers. 
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • !LINK! is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Nocardiosis. Click on the link to view a sample search on this topic.

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  1. Nocardia infection. Medline plus. 12/7/2014; http://www.nlm.nih.gov/medlineplus/ency/article/000679.htm.
  2. Nocardiosis Diagnosis and Treatment. Centers for Disease Control and Prevention. March 30, 2016; https://www.cdc.gov/nocardiosis/treatment/index.html.
  3. Spelman D. Treatment of nocardiosis. UpToDate. August 15, 2017; https://www.uptodate.com/contents/treatment-of-nocardiosis.
  4. Nocardiosis. Center for Disease Control and Prevention (CDC). March 30, 2016; https://www.cdc.gov/nocardiosis/treatment/index.html.
  5. Kurdgelashvili G. Nocardiosis. Medscape Reference. Feb 16, 2016; http://emedicine.medscape.com/article/224123.