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

Nocardiosis - pulmonary

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.

• 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

• 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

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.

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.

• Brain abscesses
• Skin infections

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

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.

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.