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Bacterial Infection (nocardiosis)

Bacterial Infection (nocardiosis)

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Published by Brijesh Singh Yadav
Thias article give the general information about Bacterial Infection (nocardiosis)
Thias article give the general information about Bacterial Infection (nocardiosis)

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Published by: Brijesh Singh Yadav on Dec 12, 2009
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01/13/2013

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Nocardiosis
Brijesh Singh Yadav
 
 
Disease Type:
Bacterial Disease
Common Name:
 Nocardiosis
Causative Agent:
Nocardia asteroides
Disease Discription:
 
A rare, acute,chronic suppurativeinfectious disease caused by bacteria
 Nocardia asteroides
which primarily affects the lung but may also involve the brain, softtissues and other organs .It has a pronounced tendency to remission and exacerbation.
 Fig.1.
 Nocardia
skin lesion
.2.
Filamentous bacteria identified as
nocardiaasteroides in
sputum.
 
Causes of Disease:
 Nocardiosis is an infection caused by bacteria (
 Nocardia
) which live in the soil. If inhaled, the bacterialinfection causes pneumonia-like symptoms leading to blood poisoning (sepsis) and the spread of nocardiosis to other organs of the body
 
 but brain and skin infections are the most common complications. Nocardia may also infect the skin through a cut, puncture wound, or scratch that occurs whileworking outdoors or gardening. The skin infections, which may take different forms, arecalled cutaneous nocardiosis. Occupational exposure to soil, as in fieldwork, landscaping,and farming, increases the risk of contracting cutaneous nocardiosis. Pulmonary anddisseminated infections occur through inhalation and primary cutaneous disease through soil-contaminated wounds. Rarely, nosocomial postsurgical transmission occurs.
Risk Factors:
 
Having a risk factor for Nocardiosis makes the chances of getting a condition higher but doesnot always lead to Nocardiosis. Severely immunocompromised persons (e.g., persons withmalignancy, connective tissue disorders, bone marrow or solidorgan transplantation, high-
 
dose corticosteroid use, HIV infection, alcoholism or pulmonary alveolar proteinosis, andmales (ratio male: female = 3:1).
Causative Agent Description:
Pathogen Name:
 Nocardia
Pathogen Description
: Nocardia is agenusof Gram-positive, catalase-positive,rod-shaped  bacteria. It has total 85 species. Some species are non pathogenic; some species are pathogenic(nocardiosis). Nocardia are found worldwide in soil that is rich with organic matter. Most Nocardia infections are acquired by inhalation of the bacteria or throughtraumatic introduction.
T
axonoimic Classification:
Kingdom
Bacteria
PhylumActinobacteriaOrderActinomycetalesSuborderCorynebacterineaeFamilyNocardiaceaeGenusNocardia
Fig.4
 Nocardia filamentous bacteria
 Other Pathogenic speices:
Other pathogenic species include
 N. farcinica, N. nova, N.transvalensis,N. brasiliensis
, and
 N. pseudobrasiliensis
. A recent report of infections with
 Nocardia cornea, Nocardia elegans, Nocardia paucivorans, Nocardia puris,
and
 Nocardiatakedensis
has come from Japan.
 Nocardia brasiliensis
is a common cause of localized chronicmycetoma. A total of approximately 30 strains of 
 Nocardia
have been associated with humandisease.
Morphology and toxin production:
 The
 Nocardia
do not have complex growth requirements. They grow well on mostcommonly used routine bacteriologic media. They usually require a minimum of 48 to72hours before colonies become visible. They maymanifest extremely variable colonial morphologies ondifferent culture media. They are dry, chalky, rough,folded, irregular and powdery.
 Nocardia
colonieshave a variable appearance, but most species appear to have aerial hyphae when viewed with a dissectingmicroscope particularly when they have been grownon nutritionally-limiting media.
 Nocardia
growslowly on non-selective culture media, and are strictaerobes with the ability to grow in a wide temperaturerange. Some species are partially acid fast(meaningthat a less concentrated solution of hydrochloric acidshould be used during the staining procedure) due tothe presence of intermediate-length mycolic acids in their cell wall. Majority of strains possess the cord factor(trehalose 6-6' dimycolate),an important virulence factor.
 
History
:
 Nocard, a French microbiologist and veterinary pathologist, first isolated
 Nocardia
in 1888and described the species
 Nocardia faraneux
, a lymphatic and visceral disease of oxen.
 Nocardia
infections in humans range from chronic skin lesions to a progressive pulmonarydisease with documented haematogenous dissemination to virtually any organ in the body
.
Epidemiology:
 
Although nocardiosis has been diagnosed in individuals with no detectabledeficiency of humoral or cell-mediated immunity, it usually occurs in patients whoseimmune status has been compromised by post-transplant immunosuppressive therapy,leukemia, lymphoma, dysgammaglobulinemia, pancytopenia, humoral defects, chronicgranulomatous disease, or steroid therapy. The male/female ratio in nocardiosis isapproximately 2:1, and infections occur from infancy to old age. There is no apparentgeographic clustering of cases in the United States, except for cutaneous infection with
 N brasiliensis
, which is more common in the south.
Disease Host:
Both normal and immunocompromised
 
humans and animals.
Disease Transmission:
 
 Nocardiosis is sporadic and person-to-person spread is not well documented.
 Nocardia
are parasitic bacteria which grow and reproduce on organic material. Their man habitat iscarbon-rich sources such as soils, and plant and animal tissues. In fact, they can be foundalmost anywhere. One environmental survey found
 Nocardia
in "beach sand, swimming pools, house dust, and garden soil". Upon infection of a plant or animal host, it metabolizesnecrotizing tissues for energy and nutrients. Because
 Nocardia
can form endospores,transmission of the bacteria "aerogenically" from one host to another is relatively easy, andthe bacteria can survive dormantly when food sources are not present.As stated,
 Nocardia
infections can be transmitted aerogenically to host respiratory systems or cutaneous wound sites, they can be introduced by innoculation (puncture wounds with the bacteria contaminant), and through fluid contact (ex: case reported of keratitis due tocontaminated contact lenses). Infection, once contracted, may spread systemically(dissemination).

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