Nocardia

Nocardia are aerobic bacteria or actinomycetes that occur worldwide. Several species exist, which mainly cause pneumonia as well as systemic disease. In 30 cases of HIV patients with nocardiosis, the lungs were affected in 21 cases (Uttamchan-dani 1994). Pulmonary nocardiosis is often confused with tuberculosis. Extrapul-monary manifestation may occur in the skin, brain, nerves, muscle and bone. The immune response to Nocardia is cellular, and the risk of developing the disease is therefore generally high in immunosuppressed patients. In HIV infected patients, however, infections with Nocardia are rather rare. Patients are usually significantly immunocompromised (Javaly 1992, Uttamchandani 1994). Nocardia respond well to sulfonamides such as sulfadiazine even in HIV infected patients (Pintado 2003). In cases of suspected nocardiosis, an experienced laboratory should be consulted.

References

1. Javaly K, Horowitz HW, Wormser GP. Nocardiosis in patients with human immunodeficiency virus infection. Report of 2 cases and review of the literature. Medicine (Baltimore). 1992, 71:128-38.

2. Pintado V, Gomez-Mampaso E, Cobo J, et al. Nocardial infection in patients infected with the HIV. Clin Microbiol Infect 2003, 9:716-20. http://amedeo.com/lit.php?id=12925115

3. Uttamchandani RB, Daikos GL, Reyes RR, et al. Nocardiosis in 30 patients with advanced HIV infection: clinical features and outcome. Clin Infect Dis 1994, 18:348-53. http://amedeo.com/lit.php?id=94281413

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