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Detection of Nocardia species and other partially-acid fast aerobic actinomycetes in clinical specimens
When this test is ordered, the reflex test may be performed and charged.
Nocardia species and other aerobic actinomycetes can cause significant disease in immunocompromised patients. Clinical presentations can include, but are not limited to, pneumonia, skin abscess, bacteremia, brain abscess, eye infection, and joint infection.
The modified acid-fast stain can detect Nocardia species and other partially-acid fast aerobic actinomycetes directly from clinical specimens.
Reported as positive or negative
Patients whose specimens are reported as partially acid-fast positive should be considered potentially infected with Nocardia species or other aerobic actinomycetes, pending definitive diagnosis by molecular methods or culture.
Artifacts may exhibit nonspecific staining and be confused with organisms. Not all aerobic actinomycetes stain as partially acid-fast. A negative stain does not rule out the possibility of infection and culture should be performed. Nocardia species and other aerobic actinomycetes grow well on mycobacterial culture medium so CTB / Mycobacteria and Nocardia Culture, Varies should be ordered. Sometimes, Nocardia species can also be recovered in fungal cultures (FGEN / Fungal Culture, Routine).
Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ: Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 2006 Apr;19(2):259-282