Nocardia bacteria enter into the body when contaminated soil touches the skin directly on open wounds or cuts. Subsequently it would release certain factors (virulence factor) which would escape the regular defense mechanism of the body. It would produce various cord factors that arrests the activity of oxygen metabolites which would otherwise create toxic substances to destroy bacteria.
Similarly these factors would prevent the action of macrophages of your body which would crush them. Nocardial bacteria would often attack lungs causing pneumonia like infection. For some people it would cause skin infection and in rare cases it attacks central nervous system and eyes.
Nocardiosis Symptoms :
The symptoms of nocardiosis differ according to the part of the body that is getting infected.
- Lung Infection :
About 90% of the reported cases already have lung disease. Pneumonia that develops by nocardia is not the same as regular pneumonia. Here the person would have chronic lung infection which shows no response to empirical antibiotics. The affected person may show signs like severe cough, fever, anorexia, loss of sweat, night sweating and chest pain. In addition to the above signs, some people may also develop sinusitis and laryngitis infection.
- Skin Infection :
Nocardia bacterium would infect the skin causing ulcers and lesions on it. Painful granulomas can be seen on the extremities of the body in addition to head and neck which is called as mycetoma. The lesions would be present for weeks together and even for months attacking deep lying organs of the skin. Skin infection can also be of lymphocutaneous type with enlarged lymph nodes and central lesions surrounded by pus. People who develop nocardiosis pneumonia are likely to develop disseminated nocardiosis in which the bacteria will gain entry into the blood and other vital organs.
- CNS :
About 30% of the reported nocardiosis infection is at risk of developing infection on the central nervous system. Such people will show symptoms like fever, headache, and seizures and reduced focus.
- Eye Infection :
Keratitis is the common eye infection caused by nocardiosis.
- Idiopathic symptoms. There are limited people who may not show any symptoms even when affected with nocardial bacteria.
Diagnosis :
Based on the symptoms and severity of infection, the doctor would order for series of testing procedures like blood profile, biopsy of tissue sample from the lungs, bronchoscopic test, skin biopsy or brain biopsy.
Treatment :