Contagious and other aspects of nocardiosis in the compromised host

Nocardiosis is an uncommon infection caused by an aerobic actinomycete. It has been recognized with increasing frequency during the past 15 yr. The immunosuppressed host is more susceptible to this opportunistic infection and cases have been described in young infants, in children with acute lymphocytic leukemia, carcinoma, chronic granulomatous disease, hypogammaglobulinemia and malnutrition and in adults after renal transplantation. Nocardiosis in the compromised host may be successfully treated if the diagnosis is made early while the infection is localized. The diagnosis is made by cultural isolation of the organism from the granulomatous lesions or infected secretions. Prolonged treatment with sulfonamides for up to 4 mth or longer is the treatment of choice. The temporal relationship of contact among three patients in this series suggests for the first time, the possibility of man to man transmission.