Nocardia are a branching,beaded, filamentous, gram-positive, weakly acid-fast


-It occurs most commonly in males

Symptoms & Signs

Pulmonary disease: the most common presentation of nocardiosis; it is initiated by inhalation of bacteria; fever, malaise, loss of weight, night sweats, cough, purulent sputum, hemoptysis, pleuritic chest pain

Skin disease: cellulitis, abscess,  lymphocutaneous nodules in a sporotrichoid pattern

Systemic disease: by hematogenous spread; brain abscess, meningitis 


Culture of sputum, pus, spinal fluid: Gram positive, filamentous bacteria weakly positive with acid-fast staining 

CXR: single or multiple nodular infiltrates 


Trimethoprim-sulfamethoxazole (Drug of choice)

Alternative agents: Minocycline, linezolid,amoxicillin/clavulanic acid, amikacin, ceftriaxone, imipenem 

Q. What is the most common presentation of nocardiosis?  Pulmonary disease

Q. What is the drug of choice to treat nocardiosis? Trimethoprim-sulfamethoxazole