title: Clinical spectrum and outcome of Nocardia infection: experience of 15-year period from a single tertiary medical center.
abstract: BACKGROUND
  Nocardiosis, although very rare, is considered as an important opportunistic infection; however, recent literature is limited. This study describes all cases of nocardial infection treated in the authors' hospital to provide more information about clinical manifestations, species isolated, treatment and outcome of patients with nocardiosis.
  
  
  METHODS
  A retrospective review of the clinical features and outcome of nocardial infections was conducted during a 15-year period (1996-2010) at Rambam Health Care Campus.
  
  
  RESULTS
  The study included 53 patients with nocardial infection, 43 of them had underlying immunodeficiency. The most common clinical form was pulmonary nocardiosis with and without dissemination (60%), followed by skin and soft tissue infection (21%), bacteremia (11%) and pertonitis (5%). Resistance to trimethoprim/sulfamethoxazile was detected in 15% of isolates; to imipenem in 5% and to ciprofloxacin in 65%. Overall mortality was 25% (13/53), mainly observed in patients with pulmonary involvement (37.5%).
  
  
  CONCLUSIONS
  Nocardiosis is a rare infection and mainly affects immunocompromised patients. Higher index of suspicion is needed for earlier diagnosis and treatment to improve prognosis.
authors.affiliation: Division of Pulmonary Medicine, Rambam Health Care Center, Haifa, Israel. e_hardak@rambam.health.gov.il
authors.forename: Emilia
authors.initials: E
authors.lastname: Hardak
authors.forename: Mordechai
authors.initials: M
authors.lastname: Yigla
authors.forename: Gidon
authors.initials: G
authors.lastname: Berger
authors.forename: Hannah
authors.initials: H
authors.lastname: Sprecher
authors.forename: Ilana
authors.initials: I
authors.lastname: Oren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult