Nocardia actinomycosis
Introduction
Introduction to Nocardi Actinomycosis This is an acute or chronic, often diffuse granulomatous-suppurative infection, usually caused by a soil-soiled aerobic Gram-positive bacillus, Nocardia. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: blood transmission Complications: abscess multiple organ dysfunction syndrome
Cause
The cause of nocardiosis
Nocardia is a chronic infectious disease caused by Nocardia. This disease is mainly caused by skin wound infection. In a few cases, it can also be infected through the respiratory tract. In addition to dogs, cats and silver. Economic animals such as foxes, moles, and otters can also be infected.
Nocardi actinomycosis is not common but is distributed throughout the world and can occur in all age groups, but the incidence is high in older men, lymphatic reticular system malignancy, organ transplantation, high dose corticosteroids or other immunosuppressants Treatment is a good cause, but about half of the patients have no pre-existing disease. This disease has been considered as an opportunistic infection in patients with advanced AIDS. Other Nocardia can sometimes cause local or even systemic infection.
Prevention
Nocardi actinomycosis prevention
There is no specific vaccine prevention for this disease, mainly to clean the skin and kennel, prevent trauma, and find that the trauma should be rubbed with purple syrup or iodine in time. For mild cases that only occur on the skin of the body surface, only Surgical treatment of abscess can be cured, if combined with the use of sulfa drugs, can improve its efficacy, but the dose should be sufficient, the course of treatment should be long, commonly used drugs are compound sulfamethoxazole, minocycline (dosage 3 mg / kg Weight, time, 2 times a day), doxycycline, erythromycin, gentamicin, etc., have a strong antibacterial effect on the bacteria, can also be combined with sulfa drugs and ampicillin, while treatment Surgical treatment such as abscess drainage and necrotic tissue resection must be combined.
Complication
Nocardi actinomy complications Complications, abscess, multiple organ dysfunction syndrome
New abscesses often appear around the lesion or other parts, and the pathogen can be transferred to other tissues and organs with the blood, and the dysfunction of the corresponding tissues and organs occurs.
Symptom
Nocardi Actinomy Symptoms Common Symptoms Cold Brain Abscesses Poor Lung Infection
Diffuse nocardia actinomycosis usually begins with a pulmonary infection, which can be similar to actinomycosis, but Nocardia actinomycetes are more often blood-borne and form brain abscesses, or rarer in the kidneys or other Multiple organs form an abscess. Skin or subcutaneous abscess often occurs, sometimes as the primary site of local infection, the most common symptoms of lung disease are cough, fever, chills, chest pain, weakness, anorexia and weight loss. However, these symptoms are non-specific and similar to tuberculosis or suppurative pneumonia. Pleural effusion can also occur, and metastatic brain abscess can occur in about 1/3 of cases. There are usually severe headaches and focal neurological abnormalities. The infection can be acute, subacute or chronic.
Examine
Check of nocardiosis
1. Laboratory examination of the fungal direct microscopic examination showed that the slender mycelium positive for Gram staining was positive for acid-fast staining.
2, histopathological examination for suppurative meat and swollen inflammation, visible in the center of the granules, sometimes surrounded by sphincter sheath, surrounded by neutrophils, lymphocytes, foreign body giant cells and plasma cells infiltration, blood vessels and their surrounding hyperplasia Phenomenon, can be seen Gram staining positive slender branch silk.
Diagnosis
Diagnosis and identification of nocardiosis
diagnosis
Diagnosis can be made from specimens or tissue cultures obtained by physical examination, X-ray examination or other imaging examinations for local lesions. The weakly acid-resistant bead clusters and branches of Gram-positive bacilli are often seen. Filament (modified acid-resistant staining with sulfuric acid decolorization instead of glycolic acid used for staining with M. tuberculosis). Nocardia is not as stick-like as Actinomyces.
Differential diagnosis
Ulcerative skin tuberculosis: more common in children with small neck and inferior chest and inguinal skin lesions in the early stage of the soy nodules of the size of the soybeans can move hard and painless and skin adhesions followed by cheese-like necrosis and formation of the fistula A pathological examination of atrophic short marks is a tuberculous granulomatous change.
Should be identified with a variety of lung diseases, bacterial brain abscess, sarcoma, advanced syphilis.
