From Big Medical Encyclopedia

NOCARDIOSIS (nocardiosis; synonym: actinomycosis of atipicheskiya, kladotrikhoz, streptotrichosis) — the infectious disease of the person and animals caused by pro-actinomycetes — nokardiya.

The etiology and a pathogeny

Activators H. belong to the class Actinomycetes (see. Actinomycetes ), this. To Actinomycetaceae, the sort Nocardia (according to S. Ya. Vaksman) or Proactinomyces (according to N. A. Krasilnikov). The most frequent activator H. — Nocardia asteroides; during the coloring across Gram, Tsil — Nesle hay, to Veygert, etc. is found in the form of thin (0,8 — 1,5 microns) sticks, kokkobakteriya, threads of various length. Nokardy — aerobes, a dispute and capsules do not form, well grow on a sugar beef-extract agar, Saburo's circle (see. Saburo of the environment ), forming smooth, pasty, and then dry, kroshko-vaty colonies grayish-white in the beginning, yellowish or (is later) than brick-red color. N.'s development is promoted by long therapy by the corticosteroids, immunodepressants, cytostatics and other pharmaceuticals leading to development of dysbacteriosis. The most frequent way of infection — aerogenic. N.'s pathogeny is studied insufficiently.

In the USSR the disease meets seldom.

A clinical picture

At N. hl are surprised. obr. lungs (infiltrates in pulmonary fabric, inclined to merge and abscessing are formed); at the same time the wedge, a picture reminds tuberculosis (see. Tuberculosis of a respiratory organs ), actinomycosis (see) and deep mycoses, napr, histoplasmosis (see). Process usually accepts septicopyemic character with formation of the centers of defeat in various fabrics and bodies. Abscesses of a brain, meningitis are possible. On skin nodes, the fistulose courses and the papillomatous centers can appear.

Diagnosis establish on the basis a wedge, pictures and datas of laboratory (bakterioskopichesky, histologic, cultural diagnosis, infection of experimental animals). The differential diagnosis with tuberculosis, an actinomycosis, deep mycoses is carried out only on the basis of datas of laboratory.

Treatment carry out by streptocides, antibiotics of a broad spectrum of activity, drugs of a sulfonic row; vaccinotherapy is recommended by the killed cultures of nokardiya.

Forecast at generalization of process adverse.

Prevention it is not developed. It is necessary to be careful at long therapy by corticosteroids, immuno depressants, cytostatics.

Bibliography: Cat's P. N. and Sheklakov N. D. Guide to a medical mycology, page 295, M., 1978; Emmons of Page W. and. the lake of Medical mycology, Philadelphia, - 1977.

H. D. Sheklakov.