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Harrison's Principles of Internal Medicine, 18e | Part 8. Infectious Diseases > Section 7. Miscellaneous Bacterial Infections > | Chapter 162. Nocardiosis Sections: Nocardiosis: Introduction, Further Readings. Topics Discussed: nocardia infections. Excerpt:"Nocardia species are saprophytic aerobic actinomycetes and are common worldwide in soil, where they contribute to the decay of organic matter. More than 50 species have been identified, mostly on the basis of 16S rRNA gene sequences. More than 30 species have been associated with human disease. Until recently, isolates from the majority of cases of pneumonia and systemic disease were identified as Nocardia asteroides, but human disease involving N. asteroides proper is actually rare. Nocardiae are relatively inactive in standard biochemical tests, and speciation is difficult or impossible without molecular phylogenetic techniques. Most clinical laboratories cannot speciate isolates accurately and may identify them simply as N. asteroides or Nocardia species.Nocardiosis occurs worldwide. The annual incidence has been estimated on three continents (North America, Europe, and Australia) and is 0.375 cases per 100,000 persons. The disease is more common among adults than among children and among males than among females. Nearly all cases are sporadic, but outbreaks have been associated with contamination of the hospital environment, solutions, or drug injection equipment. Person-to-person spread..."
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