Lung - nontumor - Nocardia

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Lung-nontumor

Infections

Nocardia

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 2 February 2012, last major update September 2011
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

Clinical features
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● Ubiquitous saphrophyte; disease caused by inhalation or direct implantation into skin
● More than 30 species with clinical significance (Clin Microbiol Rev 2006;19:259)
● Opportunistic lung infection associated with transplantation, chemotherapy, immunosuppression, steroids
● Disease is relatively uncommon in HIV likely due to sulfonamide prophylaxis directed against P. jeroveci; HAART treatment may be effective (Can J Infect Dis Med Microbiol 2009;20:e103)
● Complication of alveolar proteinosis

Clinical images
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White colonies

Gross images
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Abscess

Micro description
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● Focal bronchopneumonia with microabscesses, variable histiocytic response and ill-defined granulomas
● If identified by anatomic pathologist, clinical microbiology laboratory should be notified as routine culture may not isolate the organism

Micro images
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Small abscess

Nocardia brasiliensis

Gram stain

Modified acid fast stain shows weakly acid fast branching, filamentous bacilli

Modified Fite stain

Positive stains
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● Modified acid fast, Fite, gram stain and GMS
● Gram stain: slender, slightly beaded, branching filamentous bacilli

End of Lung-nontumor > Infections > Nocardia

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