Nocardiosis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overall, 80% of nocardiosis cases present as invasive pulmonary infection, disseminated infection, or brain abscess; 20% present as cellulitis. Pulmonary infection commonly presents with fever, cough, or chest pain. Central nervous system (CNS) symptoms include headache, lethargy, confusion, seizures, or sudden onset of neurologic deficit.

• night sweats, fever, cough, chest pain
• Pulmonary nocardiosis is subacute in onset and refractory to standard antibiotherapy
• symptoms are more severe in immunocompromised individuals
• radiologic studies show multiple pulmonary infiltrates with tendency to central necrosis

• Headache, lethargy, confusion, seizures, sudden onset of neurological deficit
• CT scan shows cerebral abscess
• Nocardial meningitis is very rare and difficult to diagnose

• Nocardial cellulitis is akin of erysipela but is more subacute
• Nodular lymphangeitis mimics sporotrichosis with multiple nodules alongside a lymphatic pathway
• Mycetoma is a rare complication and osteitis may ensue .

• Very rarely nocardiae cause keratitis
• Gennerally there is a history of ocular trauma

• Disseminated infection can occur in very immunocompromised patients
• It generally involves both lungs and brain
• Fever, moderate or very high can be seen
• Multiple cavitating pulmonary infiltrates develop
• Cerebral abscesses arise later
• Cutaneous lesions are very rarely seen
• If untreated, the prognosis is grim for this form of disease

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