Nocardiosis

Nocardiosis is an infectious disease affecting either the lungs (pulmonary nocardiosis) or the whole body (systemic nocardiosis). It is due to infection by bacterium of the genus Nocardia, most commonly Nocardia asteroides or Nocardia brasiliensis.

It is most common in men, especially those with a weakened immune system. In patients with brain infection, mortality exceeds 80%; in other forms, mortality is 50%, even with appropriate therapy.

It is one of several conditions that have been called the great imitator. Cutaneous nocardiosis commonly occurs in immunocompetent hosts.

Causes

Normally found in soil, these organisms cause occasional sporadic disease in humans and animals throughout the world. Another well publicized find is that of Nocardia as an oral microflora. Nocardia spp. have been reported in the normal gingiva and periodontal pockets along with other species such as Actinomyces, Arthromyces and Streptomyces spp.

The usual mode of transmission is inhalation of organisms suspended in dust. Another very common method is that by traumatic introduction, especially in the jaw. This leads to the entrance of Nocardia into the blood stream and the propagation of its pathogenic effects. Transmission by direct inoculation through puncture wounds or abrasions is less common. Generally, nocardial infection requires some degree of immune suppression.