ACCP Pulmonary Medicine Board Review 25th Edition

ACCP Pulmonary Medicine Board Review 25th Edition

Nocardiosis refers to invasive disease caused by members of the genus Nocardia. Respiratory
tract disease and extrapulmonary dissemination are the most common manifestations. Pulmonary
infection is increasingly seen in immunosuppressed patients, particularly those with defects in
cellular immunity.

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Other presentations include cellulitis, lymphocutaneous syndrome, actinomycetoma,
and keratitis. Nocardia species are aerobic, nonmobile, and non-spore-forming organisms that
live as soil saprophytes. In tissue specimens, the organisms reveal delicate branching fi lamentous
forms that are Gram-positive and usually acid fast if weak decolorizing agents are used for the stains.
Seven species have been associated with human disease. Nocardia asteroides is the most common
species associated with invasive disease. Nocardia farcinica is less common and is associated with dissemination.
Other species known to cause human infection are Nocardia pseudobrasiliensis and Nocardia
brasiliensis.

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