SYSTEMIC NOCARDIOSIS

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SYSTEMIC NOCARDIOSIS
Systemic Nocardiosis:
 It is a rare infectious disorder which affects the lungs or the entire body means it become systemic and
causes disease in different parts of the body.
 Such as lungs, CNS, GIT, skin, heart, kidneys, eyes, muscles and joints infections.
 Bacterium from the genus Nocardia,especially Nocardia asteroides and Nocardia brasiliensis,is mainly
responsible for the occurrence of this condition.
 The infection can be dangerous for people who have weak immune systemis result of anothermedical
condition such as cancer or HIV.
 It is most commonly in male than female.
 It causes diseases in humans and as well as cats,dogs,birds, fishes and cattle.
Etiology:
 The causative agents of systemic Nocardiosis are Nocardia asteroides , Nocardia brasiliensis , N- cancava,
N- africana and N- cornea.
 Nocardia asteroides , Nocardia brasiliens is are most common in systemic nocardiosis.
 That is normaly found in soil, water and can enters into the human body when a person inhales the
contaminated dust through breathing.
 The bacteria initially lead to pneumonia, which may cause sepsis or blood poisoning.
 In this way, the infection may gradually spread to other areas of the body such as skin and brain.
 The condition is referred to as disseminated Nocardiosis when it occurs in this manner.
Epidemiology:
 Occur in worldwide .
 Earlier report estimate that incidence of nocardiosis in the united states at 500 to 1000 cases per year.
 In about 60% of theses cases the infection is related to a weak immune system.
International
 Rate of nocardiasis vary by country, for example in Japan 45 patients with cutaneous nocardiasis were
reported by 1985.
 Approximately 90% of those patients had mycetoma.
Mortality:
In patients with brain abscess the mortality rate is 80% and in other form the mortality is 50%.
Sex
The male to female ratio is 3 ratio 1 in all form of systemic nocardiasis.
Age
Nocardiasis occur in all ages but aged people and children susceptible to nocardiosis due to weak immune system.

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Risk factors:
 Risk factors are the following
 Cancer patients
 HIV AIDS
 Diabetes
 Chronic lung disease
 Bone marrow or organ transplantation
 The long term use of steroids medication
 Intravenous drug abusers.
Transmission:
 Respiratory tract is special route for pulmonary and systemic nocardiasis infection .
 Contact of wounds with contaminated soil or still water.
 In the jaw this leads to the entrance of Nocardia into the blood stream and causing systemic nocardiasis.
 Contaminated medial equipment's also transfer the nocardiasis.
Sign and Symptoms of Systemic Nocardiosis:
Entire Body Symptoms
 Recurring fever ( Fever occurring again and again)
 Malaise or Discomfort ( Feeling not good )
Lung Symptoms
 Breathing difficulty
 Cough
 Rapid breathing
 Chest pain which not related to any heart problems
 Shortness of breath
 Coughing up blood
Gastrointestinal System Symptoms:
 Nausea ( Feeling to like Vomiting )
 weight loss
 swelling of the liver and spleen
 Vomiting
Skin Symptoms
 Skin lumps or Rashes
 Abscessesorskin sores
 Swollen lymph nodes
Central Nervous System Nocardiosis:`
 Once the Nocardiosis spread through the bloodstream, it can cause a systemic Nocardiosis .
 When Nocardiosis infect the central nervous system(CNS) then it is known as CNS Nocardiosis.

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 CNS Nocardiosis occurs mostly in the Brain.
 Brain abscessesoccurs when a swollen area within brain tissue,containing an accumulation of pus.
 Death is more likely to occur in CNS nocardiosis.Antibiotic therapy needs immediately.
Central Nervous System Nocardiosis :
Brain Abscesses
 Pulmonary Nocardiosis is the usualcause of an abscess in the brain.
 CNS infection occurs in more than 40% of cases of Systemic Nocardiosis.
 Brain abscessestend to occurin those with weakened immune systems.
 The infection will cause your brain to swell from the collection of pus and dead cells that form Abscesses.
 Heart and lung infections are among the most common causes ofbrain abscesses.
 CNS Nocardiosis less common to occur than otherNocardiosis infections.
 But when it occurs in the brain, Death is more likely to occur in CNS nocardiosis than other Nocardiosis
infection .
 Antibiotic therapy needs immediately.
Sign and Symptoms of CNS Nocardiosis:
Nervous System Symptoms
 Confusion
 Headache
 Dizziness
 Seizures
 Changes in mental state
Muscle and Joint Symptoms
 Joint pain
Brain Symptoms
 Fever
 Seizures
 Headache
 Cerebral abscesses (a swollen area within brain tissue,containing an accumulation of pus)
How Is Systemic Nocardiosis Diagnosed
 A chest X-ray is an imaging test that produces detailed images of the lungs.
 A bronchoscopy is a test in which your doctoruses a thin tube with an attached camera to view the lungs.
 A brain biopsy is a procedure that involves removing a small sample of abnormal brain tissue.
 A lung biopsy is a procedure that involves removing a small sample of abnormal lung tissue.
 A skin biopsy is a procedure that involves removing a small sample of abnormal skin cells.
 A sputumculture is a procedure that involves taking a small sample of mucus
 CT (Computerized Tomography ) and MRI (Magnetic Resonance Imaging) scans can also be used to
diagnose a brain abscess.

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How Systemic Nocardiosis Treated?
 All cases of nocardiosis should be treated with long-term and low-dose antibiotics known as sulfonamides.
 Treatment typically lasts from six months to a year.
 However, more severe infections may require treatment for a longer period.
 Penicillin is not used in this treatment.
 As the Nocardia bacteria are penicillin-resistant.
 Sulfamethoxazole-trimethoprim (Bactrim) is most commonly used for treating Nocardiosis.
 No Vaccination is available
Prevention:
 Prevention may be difficult in susceptible individuals.
 taking some preventive measures can decrease their risk of developing the disease.
 They should avoid working outdoors without protection.
 Wearing gloves and socks can prevent the skin from coming into direct contact with the soil.
 This measure should also be adopted by healthy individuals to avoid the disorder.
 Taking Trimethoprim or sulfamethoxazole prophylaxis during the first six months after undergoing organ
transplantation can help to prevent the condition.