Differentials
Tuberculosis
SIGNS / SYMPTOMS
Clinical differentiation is difficult. In immunocompetent patients, cavities are more frequently related to tuberculosis. In immunocompromised patients, particularly patients with AIDS, cavities are less frequently associated with tuberculosis and very common in nocardiosis.[30]
INVESTIGATIONS
Mycobacterium can be differentiated from Nocardia in clinical samples, because mycobacteria do not stain well with Gram stain and modified acid-fast stain. They are also microscopically different from Nocardia.[7]
Actinomycosis
SIGNS / SYMPTOMS
Clinical differentiation is difficult.
INVESTIGATIONS
Actinomyces can be differentiated from Nocardia in clinical samples, because Actinomyces is not stained by modified acid-fast stain.[7]
Lung abscess
SIGNS / SYMPTOMS
Clinical differentiation is difficult.
INVESTIGATIONS
Evidence of Nocardia species in sputum or other specimens allows differentiation.
Brain abscess
SIGNS / SYMPTOMS
Clinical differentiation is difficult.
Pulmonary and disseminated opportunistic fungal infections
SIGNS / SYMPTOMS
Clinical differentiation is difficult.
INVESTIGATIONS
Evidence of filaments, detection of fungal antigens or nucleic acids, and fungal cultures in sputum or other specimens allow differentiation.
Toxoplasmosis
SIGNS / SYMPTOMS
Clinical differentiation is difficult.
INVESTIGATIONS
Evidence of Nocardia in other clinical specimens, Toxoplasma serology, cerebrospinal fluid Toxoplasma polymerase chain reaction.
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