Nocardiosis

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Sections available in full article Introduction, Presenting signs, Cost considerations, Pathogenesis, Predisposing factors, Pathophysiology, Diagnosis, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Kim Willoughby BVMS PhD MRCVS
Dr Danielle Gunn-Moore BSc BVM&S PhD MACVSc MRCVS
Dr Stephen Barr BVSc MVS PhD DipACVIM

Introduction

  • Relatively rare bacterial disease of cats.
  • Cause : infection with Nocardia spp (usually Nocardia asteroides ).
  • Signs : vague signs of illness, dyspnea.
  • Diagnosis : pyogranulomatous lesions detected, bacterial culture.
  • Treatment : surgical drainage (or excision), antibiotic therapy.
  • Prognosis : variable to poor (depending on underlying cause).

Diagnosis

Clinical signs

  • Respiratory form:
    • Muffled respiratory sounds if pleural fluid present.
    • Cough.
    • Dyspnea.
    • Tachypnea.
  • Systemic form:
    • Pyrexia.
    • Coughing.
    • Discharges from nose and eyes.
  • Granulomatous skin lesions:
    • Abscesses.
    • Draining sinus.
    • Cellulitis.
    • Ulcerated lesions.

Diagnosis

Differential diagnosis

  • Tuberculosis  Tuberculosis  .
  • Pulmonary neoplasia (primary)  Lung: pulmonary neoplasia  .
  • Actinomycoses  Actinomycosis  .

Sequelae

Prognosis

  • Poor unless lesion can be drained and underlying cause can be addressed.
  • Over 50% of reported cases are either euthanased or die of the infection.

Expected response to treatment

  • Resolution of signs over weeks.

Reasons for treatment failure

  • Foreign body present in granuloma.
  • Underlying immunosuppression not resolved.
  • Antibiotic resistance.
  • Inadequate length of antibiotic treatment.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Hirsch D C & Jang S S (1999)Antimicrobial susceptibility of Nocardia nova isolated from five cats with nocardiosis.JAVMA215, 815-817.
  • Mealey K L, Willard M D, Nagode L A & Helman R G (1999)Hypercalcaemia associated with granulomatous disease in a cat.JAVMA215, 959-962.
  • Tigner S L & Anstey S I (1996)Nocardial peritonitis in a cat.Aust Vet J74, 430-432.
  • Davenport D J & Johnson G C (1986)Cutaneous nocardiosis in a cat.J Am Vet Med Assoc188(7), 728-729.

Other sources of information

  • Edwards D F (1998)NocardiosisIn:Infectious Diseases of the Dog and Cat.2nd Edn. Ed. Greene C E. WB Saunders Co. pp 308-312.

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