Pulmonary nocardiosis

Also known as: Nocardiosis - pulmonary

Definition

Pulmonary nocardiosis is an infection of the lung with the bacteria, Nocardia asteroides.

Causes, incidence, and risk factors

Nocardia infection develops when you breathe in (inhale) the bacteria. The infection causes pneumonia -like symptoms. The infection can spread to any part of the body.

People at highest risk for nocardia infection are those with a weakened immune system. This includes people who have:

• Been taking steroid medicines or other medicine that weaken the immune system for a long time
• Had an organ transplant
• HIV

Other people at risk include those with chronic lung problems related to smoking, emphysema, or other infections such as tuberculosis.

Symptoms

• Entire body
  • Fever (comes and goes)
  • General ill feeling (malaise)
  • Night sweats
• Gastrointestinal system
  • Nausea
  • Liver and spleen swelling (hepatosplenomegaly)
  • Unintentional weight loss
  • Vomiting
• Lungs and airways
  • Breathing difficulty
  • Chest pain not due to heart problems
  • Coughing up blood
  • Cough with mucus
  • Rapid breathing
  • Shortness of breath
• Muscles and joints
  • Joint pain
• Nervous system
  • Change in mental state
  • Confusion
  • Dizziness
  • Headache
  • Seizures
• Skin
  • Skin rashes or lumps
  • Skin sores (abscesses)
  • Swollen lymph nodes

Signs and tests

• Bronchial alveolar lavage - fluid is sent for stain and culture
• Bronchoscopy
• Chest x-ray
• Crackles (rales) in the infected lung detected by stethoscope
• CT scan
• Decreased breath sounds in the lung
• Pleural fluid culture and stain
• Sputum stain and culture

Treatment

The goal of treatment is to control the infection. Antibiotics are used, but the response to treatment may be slow and you must keep taking the medications for at least 3 months.

Surgery may be needed to remove or drain infected areas.

Expectations (prognosis)

The outcome is often good when diagnosed and treated quickly.,

The outcome is poor when the infection spreads outside the lung, treatment is delayed, or the patient has serious underlying diseases.

Complications

• Brain abscesses
• Skin infections

Calling your health care provider

Call your health care provider if you have symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome.

Prevention

Be careful when using corticosteroids. Use these drugs sparingly, in the lowest effective doses and for the shortest periods of time possible.

Some patients with an impaired immune system may need to take antibiotics for long periods of time to prevent the infection from returning.

References

Torres A. Pyogenic Bacterial Pneumonia and Lung Abscess. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.

See also:

• Disease

  Obesity hypoventilation syndrome (OHS)

  

  Obesity hypoventilation syndrome (OHS) is a condition that occurs in obese people, in which poor breathing leads to lower oxygen levels and higher carbon dioxide levels in the blood.

• Disease

  Flu

  

  The flu is an infection of the nose, throat, and lungs caused by the influenza virus. See also: (H1N1)

• Disease

  Collapsed lung

  

  A collapsed lung, or pneumothorax, is the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

• Disease

  Mycoplasma pneumonia

  

  Mycoplasma pneumonia is an infection of the lungs from the bacteria Mycoplasma pneumoniae (M. pneumoniae). See also:

• Special Topic

  Chronic

  

  Chronic refers to something that continues or persists over an extended period of time. A chronic condition is usually long-lasting and does not easily or quickly go away. Chronic is the opposite of .

• Disease

  Type 1 diabetes

  

  Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels. See also:

• Disease

  Type 2 diabetes

  

  Type 2 diabetes is a chronic (lifelong) disease marked by high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. See also:

• Disease

  Pleural effusion

  

  A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.

• Kidney stones - lithotripsy - discharge

  Extracorporeal shock wave lithotripsy – discharge; Shock wave lithotripsy – discharge; Laser lithotripsy – discharge; Percutaneous lithotripsy – discharge; Endoscopic lithotripsy – discharge; ESWL – discharge

• Disease

  Pneumomediastinum

  

  Pneumomediastinum is air in the mediastinum. The mediastinum is the space in the middle of the chest, between the lungs.

• Disease

  Brain abscess

  

  A brain abscess is a collection of immune cells, pus, and other material in the brain, usually from a bacterial or fungal infection.

• Disease

  Mediastinitis

  

  Mediastinitis is swelling and irritation (inflammation) of the area between the lungs (mediastinum). This area contains the heart, large blood vessels, windpipe (trachea), esophagus, thymus gland, lymph nodes, and connective tissues.

• Disease

  Pulmonary tuberculosis

  

  Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs, but may spread to other organs.

• Disease

  Primary alveolar hypoventilation

  

  Primary alveolar hypoventilation is a rare disorder of unknown cause in which a person does not take enough breaths per minute. The lungs and airways are normal.

• Disease

  Atypical pneumonia

  

  Atypical pneumonia refers to pneumonia caused by certain bacteria, including Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae. Pneumonia is a condition in which there is an infection of the lung.

• Disease

  Chronic cholecystitis

  

  Chronic cholecystitis is swelling and irritation of the gallbladder that persists over time. The gallbladder is a sac located under the liver. It stores bile that is made in the liver. Bile helps the intestines digest fats.

Review date:

September 17, 2010

Reviewed by:

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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