State-of-the-Art Review: Modern Approach to Nocardiosis-Diagnosis, Management, and Uncertainties

Clin Infect Dis. 2025 Apr 30;80(4):e53-e64. doi: 10.1093/cid/ciae643.

Abstract

Nocardiosis is an uncommon yet potentially devastating infection. Nocardia tends to affect individuals with chronic lung disease or immunocompromising conditions, 2 groups increasing in number. Incidence of nocardiosis is likely to increase as well, and it is vital to have an approach to this complex disease. Here, we aim to review the presentation, diagnosis, and management of Nocardia in the modern era. We will also highlight areas of uncertainty in our understanding of nocardiosis and propose a general approach to nocardiosis therapy, accounting for response and tolerance of Nocardia treatment.

Keywords: Nocardia; brain abscess; bronchiectasis; immunosuppression; trimethoprim-sulfamethoxazole.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Disease Management
  • Humans
  • Nocardia / drug effects
  • Nocardia / isolation & purification
  • Nocardia Infections* / diagnosis
  • Nocardia Infections* / drug therapy
  • Nocardia Infections* / epidemiology

Substances

  • Anti-Bacterial Agents