Human Nocardia Infections: A Review of Pulmonary Nocardiosis.

Venkataramana Kandi

doi:10.7759/cureus.304

Abstract

Human nocardiosis may present as an acute or a chronic infection. Although a saprophyte Nocardia spp are responsible for superficial skin infections, pulmonary infections, and disseminated nocardiosis usually involving patients who are immunosuppressed and debilitated. Infections in immunocompetent individuals are usually chronic and present non-specific symptoms. Invasive and disseminated nocardiosis is common among patients with weakened cellular immune systems. Clinical diagnosis of pulmonary nocardiosis is difficult owing to the similarity of its presentation with other respiratory pathogens that include Actinomycetes members and Mycobacterium tuberculosis. Laboratory diagnosis of human nocardiosis is plagued by the fact that a culture of Nocardia spp requires prolonged incubation periods for isolation which most laboratories fail to follow. The lack of clinical, laboratory, and epidemiological data on the incidence of nocardiosis in humans undermines its significance as a potential pathogen. This review attempts to reexamine the pathogenic potential of Nocardia in human infections

Highlights

BackgroundThe bacteria most commonly associated with chest infections include Haemophilus influenzae, Klebsiella pneumoniae, and Streptococcus pneumoniae, and these are the targets of antimicrobials prescribed by a physician when treating chest infections
Chest infections are caused by other bacterial species that include members of Actinomycetes, Bordetella pertussis, Mycoplasma pneumoniae, and Coxiella spp, which are difficult to cultivate in most laboratories [1,2]
It can be helpful in the management of chest diseases like acute bronchitis, chronic bronchitis, bronchiolitis, bronchiectasis, chronic pulmonary obstructive disorders (COPD), pneumonia, and cystic fibrosis, when they are chronic in nature and recurrent

Summary

Introduction

The bacteria most commonly associated with chest infections include Haemophilus influenzae, Klebsiella pneumoniae, and Streptococcus pneumoniae, and these are the targets of antimicrobials prescribed by a physician when treating chest infections. Haemophilus influenza is commonly isolated in acute bronchitis and bronchiectasis cases usually in children, young adults and geriatric age patients Tuberculosis is another most important lower respiratory tract infection affecting lungs and usually causes infections in immunocompromised, debilitated and nutritionally deprived individuals [5]. Another report which reviewed the history of human nocardiosis has revealed that clinicians should suspect infection with Nocardia and notify the same to the laboratory so that the necessary steps are taken by laboratory specialists to isolate, identify, and sensitivity pattern of the Nocardia spp [26]. A recent paper has highlighted the significance of the organ involved, its antimicrobial susceptibility pattern, and the use of combination antibiotic therapy in the treatment of human nocardiosis [37]. This study has recommended that a combination therapy including TMP/SMX, ceftriaxone and imipenem can be initiated until the sensitivity report is available [38]

Conclusions

Disclosures

Gordon MA

Findings

Ramana KV