Nocardia Infections In Solid Organ Transplantation

Nocardia commonly affects the lung, brain, and skin and may cause disseminated infection. (, )

Early recognition of nocardiosis is critical to achieving good outcomes. (, )

The diagnosis should be considered in patients with nodular or cavitating lung lesions or brain lesions and appropriate cultures and biopsies obtained. (High, Strong)

We recommend brain imaging for patients with pulmonary and disseminated nocardiosis to evaluate for CNS involvement. (Moderate, Strong)

We recommend prolonged incubation of diagnostic specimens in suspected cases of Nocardia infection, use of selective media such as Thayer‐Martin agar with antibiotics, and communication with clinical microbiology laboratory personnel to alert them to the possibility of nocardiosis. (Low, Strong)

We recommend obtaining speciation of clinical Nocardia isolates to help guide antimicrobial therapy. (Moderate, Strong)

Traditional phenotypic methods for identifying Nocardia species are inadequate, and isolates should be speciated at qualified laboratories by molecular methods. (Low, Weak)