Site Map

Nocardia infection

Nocardiosis

Nocardia infection (nocardiosis) is a disorder that affects the lungs, brain, or skin. In otherwise healthy people, it may occur as a local infection. But in people with weakened immune systems, it may spread throughout the body.

Images

I Would Like to Learn About:

Causes

Nocardia infection is caused by a bacterium. It usually starts in the lungs. It may spread to other organs, most often the brain and the skin. It may also involve the kidneys, joints, heart, eyes, and bones.

Nocardia bacteria are found in soil around the world. You can get the disease by breathing in dust that has the bacteria. You can also get the disease if soil containing nocardia bacteria gets into an open wound.

You are more likely to get this infection if you have long-term (chronic) lung disease or a weakened immune system, which can occur with transplants, cancer, HIV/AIDS, and long-term use of steroids.

Symptoms

Symptoms vary and depend on the organs involved.

If in the lungs, symptoms may include:

• Chest pain when breathing (may occur suddenly or slowly)
• Coughing up blood
• Fever
• Night sweats
• Weight loss

If in the brain, symptoms may include:

• Fever
• Headache
• Seizures
• Coma

If the skin is affected, symptoms may include:

• Skin breakdown and a draining tract (fistula)
• Ulcers or nodules with infection sometimes spreading along lymph nodes

Some people with nocardia infection have no symptoms.

Exams and Tests

The health care provider will examine you and ask about your symptoms.

Nocardia infection is diagnosed using tests that identify the bacteria (Gram stain, modified acid-fast staining or culture). For example, for an infection in the lung, a sputum culture may be done.

Depending on the part of the body infected, testing may involve taking a tissue sample by:

• Brain biopsy
• Lung biopsy
• Skin biopsy

Treatment

You will need to take antibiotics for 6 months to a year or longer. You may need more than one antibiotic.

Surgery may be done to drain pus that has collected in the skin or tissues (abscess).

Outlook (Prognosis)

How well you do depends on your overall health and the parts of the body involved. Infection that affects many areas of the body is hard to treat, and some people may not be able to recover.

Possible Complications

Complications of nocardia infections depend on how much of the body is involved.

• Certain lung infections may lead to scarring and long-term (chronic) shortness of breath.
• Skin infections may lead to scarring or disfigurement.
• Brain abscesses may lead to loss of neurological function.

When to Contact a Medical Professional

Contact your provider if you have any symptoms of this infection. They are nonspecific symptoms that can have many other causes.

References

Chen SC-A, Watts MR, Maddocks S, Sorrell TC. Nocardia species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 253.

Southwick FS. Nocardiosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 314.

BACK TO TOP

Review Date: 12/4/2022  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Health Content Provider 06/01/2025

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complied with the HONcode standard for trustworthy health information from 1995 to 2022, after which HON (Health On the Net, a not-for-profit organization that promoted transparent and reliable health information online) was discontinued.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2024 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.