infectious diseases
Nocardiosis
Symptoms and Signs of Nocardiosis
Nocardiosis usually begins as a subacute pulmonary infection that resembles actinomycosis, butNocardiaare more likely to disseminate locally or hematogenously. Dissemination with abscess formation may involve any organ but most commonly affects the brain, skin, kidneys, bone, or muscle. The most common symptoms of pulmonary involvement—cough, fever, chills, chest pain, weakness, anorexia, and weight loss—are nonspecific and may resemble those of tuberculosis or suppurative pneumonia. Pleural effusion may also occur. Metastatic brain abscesses, occurring in 30 to 50% of cases, usually cause severe headaches and focal neurologic abnormalities. Infection may be acute, subacute, or chronic. Skin or subcutaneous abscesses occur frequently, sometimes as a primary local inoculation. They may appear as Firm cellulitis Lymphocutaneous syndrome An actinomycetoma The lymphocutaneous syndrome consists of a primary pyoderma lesion and lymphatic nodules resembling sporotrichosis. An actinomycetoma due to nocardiosis begins as a nodule, suppurates, spreads along fascial planes, and drains through chronic fistulas. 