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Nocardiosis Follow-up

  • Author: George Kurdgelashvili, MD; Chief Editor: Michael Stuart Bronze, MD  more...
Updated: Feb 16, 2016

Inpatient & Outpatient Medications

Antimicrobial therapy for pulmonary or disseminated nocardiosis should be continued for 6-12 months and at least 1 month following resolution of all evidence of infection. These patients require at least 12 months of monitoring after the completion of therapy to detect possible late relapses.

Follow-up radiographic studies should be obtained to monitor treatment.

Follow-up laboratory studies are required to monitor for adverse effects of prolonged antimicrobial therapy.



Although not clearly established, prophylactic therapy for Pneumocystis jiroveci pneumonia (PCP) with TMP-SMX in patients with AIDS whose CD4 count is less than 200 cells/µL probably decreases the likelihood of nocardiosis. (For an excellent discussion of PCP prophylaxis, see the Medscape Reference article Preventing Opportunistic Infections in Patients With HIV.) Similarly, TMP-SMX prophylaxis in solid-organ transplant or hematopoietic stem cell transplant recipients may decrease the likelihood of nocardiosis. However, prophylaxis is not fully effective in either circumstance.


Patient Education

Patients with nocardiosis must be educated about the need for protracted antimicrobial therapy.

Patients with nocardiosis should be informed of the potential adverse effects of protracted antimicrobial therapy and which circumstances require reporting to their physician promptly.

Contributor Information and Disclosures

George Kurdgelashvili, MD Clinical Associate Professor of Medicine, Department of Medicine, University of Oklahoma College of Medicine; Assistant Chief of Medical Service, Director of Diagnostic Center Clinic, Chair of Infection Prevention and Control Committee, Attending Physician, Infectious Diseases Section, Oklahoma City Veterans Affairs Medical Center

George Kurdgelashvili, MD is a member of the following medical societies: Infectious Diseases Society of America, HIV Medicine Association, Veterans Affairs Society of Practitioners in Infectious Diseases

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John W King, MD Professor of Medicine, Chief, Section of Infectious Diseases, Director, Viral Therapeutics Clinics for Hepatitis, Louisiana State University Health Sciences Center; Consultant in Infectious Diseases, Overton Brooks Veterans Affairs Medical Center

John W King, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Federation for Medical Research, Association of Subspecialty Professors, American Society for Microbiology, Infectious Diseases Society of America, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Thomas J Marrie, MD Dean of Faculty of Medicine, Dalhousie University Faculty of Medicine, Canada

Thomas J Marrie, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, Association of Medical Microbiology and Infectious Disease Canada, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

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High-power microscopic appearance of Nocardia. Image courtesy of CDC.
Photomicrograph of tissue biopsy stained with Gomori methenamine silver demonstrating acute inflammatory response and organisms compatible with Nocardia.
Plain chest radiograph in a patient with nocardiosis. Image courtesy of Applied Radiology, Anderson Publishing, LTD.
Chest CT scan in a patient with pleuropulmonary nocardiosis. Image courtesy of Applied Radiology, Anderson Publishing, LTD.
Brain CT scan in a patient with nocardial brain abscess. Image courtesy of Applied Radiology, Anderson Publishing, LTD.
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