biology of nocardia?
- Branching filaments
- Weakly acid-fast
- catalase (+)
Inhalation of contaminated dust or soil entry into open wound
when is it opportunistic?
how does it avoid phagocytic killing?
- Short-chain mycolic acids* interferes with complement
- Cord factor* (glycolipid) prevents fusion of phagosome with lysosome.
what is Clinical Disease that it causes?
- Bronchio-pulmonary disease
- Cutaneous and sub-cutaneous infections
Bronchio-pulmonary disease due to nocardia is seen in whom?
Almost always in immunocomp.
nocardia Bronchio-pulmonary disease patients will present with what?
Cavitations with spread into the pleura with dyspnea, fever & cough
nocardia Bronchio-pulmonary disease looks similar to what other disease?
what are the Cutaneous and sub-cutaneous infections that nocardia causes?
Brain abscesses, Cellulitis & subcut abscesses etc
what is Mycetoma?
localized subcutaneous swellings involving underlying tissue, muscle & bone
suppuration and formation of multiple sinus tracts
(chronic granulomatous inflammatory response in the deep dermis and subcutaneous tissue.)
how do Lymphocutaneous infections look?
cut nodules and ulcerations along the lymphatics with LN involvement
nocardiosis targets primarily what patientS?
what patient history predisposes to nocardiosis?
CLL presenting with large nodules and chest pains
how do you diagnose nocardia?
Direct Gram and acid-fast staining of sputum or CSF or tissue
what is the treatment for nocardia?
Trimethoprim & Sulfamethoxazole