This bacteria requires oxygen to live and is incapable of living in environments with minimal oxygen content.
Norcardia stains positive under gram staining due to high peptidoglycan levels in the cell wall.
Nocardia is catalase positive, meaning it produces the enzyme catalase. This enzyme allows the bacteria to convert hydrogen peroxide, which is toxic, to oxygen and water.
This bacterium has the ability to produce urease, which hydrolyzes urea in the body to ammonia. In a urinary tract infection, this means that the urine becomes more alkaline. In a lab setting, urease positive bacteria are characterized by their production of a distinct, fishy odor.
An acid fast stain refers to the ability of acid to be washed off a bacterial prep often due to high mycolic acid content. Nocardia is weakly acid fast when stained. This property helps distinguish nocardia from actinomyces which has no acid fast properties.
Nocardia and actinomyces have long branching filaments, which help with their identification.
Nocardia is commonly described as a beaded filament, much like actinomyces.
Nocardial infections are classically found as pulmonary infections in immunocompromised patients.
Norcardia often originates from the soil where it is abundant.
Lung cavitation is a classic presentation of Nocardia infection in immunocompromised patients. This could present as chronic cough or hemoptysis.
Nocardia is known to cause brain abscesses in immunocompromised patients.
Norcardia infections can also present as a kidney abscess.
The treatment for patients with nocardia infection is trimethoprim-sulfamethoxazole, an antibiotic that alters bacterial folate metabolism.
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