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198 BACTERIOSESDiagnosis: Microscopic examination of exudates can indicate nocardiosis, butonly culture and identification of the agent provide a definitive diagnosis. In pulmonarynocardiosis, bronchoalveolar lavage and aspiration of abscesses or collectionof fluids can be used, guided by radiology (Forbes et al., 1990).Various serological tests have been described. An enzyme immunoassay with anantigen (a 55-kilodalton protein) specific for Nocardia asteroides yielded goodresults in terms of both sensitivity and specificity (Angeles and Sugar, 1987).Serodiagnosis in immunodeficient patients—who currently suffer more frequentlyfrom nocardiosis—is very difficult. A more recent work (Boiron and Provost, 1990)suggests that the 54-kilodalton protein would be a good candidate as an antigen fora probe for detecting antibodies in nocardiosis.Control: No specific control measures are available. Prevention consists of avoidingpredisposing factors and exposure to dust (Pier, 1979). Environmental hygieneand sterilization of instruments are important.For control of mastitis caused by Nocardia spp. in cows, it is recommended thatudder hygiene practices be adopted as well as general hygiene rules for the dairyfacility.BibliographyAngeles, A.M., A.M. Sugar. Rapid diagnosis of nocardiosis with an enzyme immunoassay.J Infect Dis 155:292–296, 1987.Beaman, B.L., J. Burnside, B. Edwards, W. Causey. Nocardial infections in the UnitedStates, 1972–1974. J Infect Dis 134:286–289, 1976.Beaman, B.L., A.M. Sugar. Nocardia in naturally acquired and experimental infections inanimals. J Hyg 91:393–419, 1983.Benenson, A.S., ed. Control of Communicable Diseases in Man. 15th ed. An official reportof the American Public Health Association. Washington, D.C.: American Public HealthAssociation; 1990.Boiron, P., F. Provost. Use of partially purified 54-kilodalton antigen for diagnosis of nocardiosisby Western blot (immunoblot) assay. J Clin Microbiol 28:328–331, 1990.Bradsher, R.W., T.P. Monson, R.W. Steele. Brain abscess due to Nocardia caviae: Reportof a fatal outcome associated with abnormal phagoctye function. Am J Clin Pathol78:124–127, 1982.Forbes, G.M., F.A. Harvey, J.N. Philpott-Howard, et al. Nocardiosis in liver transplantation:Variation in presentation, diagnosis and therapy. J Infect 20:11–19, 1990.Land, G., M.R. McGinnis, J. Staneck, A. Gatson. Aerobic pathogenic Actinomycetales. In:Balows, A., W.J. Hausler, K.L. Hermann, H.D. Isenberg, H.J. Shadomy, eds. Manual ofClinical Microbiology. 5th ed. Washington, D.C.: American Society for Microbiology; 1991.Lerner, P.L. Nocardia species. In: Mandell, G.L., R.G. Douglas, Jr., J.E. Bennett, eds.Principles and Practice of Infectious Diseases. 3rd ed. New York: Churchill Livingstone,Inc.; 1990.Liebenberg, S.P., W.E. Giddens. Disseminated nocardiosis in three macaque monkeys. LabAnimal Sci 35:162–166, 1985.Orchard, V.A. Nocardial infections of animals in New Zealand, 1976–78. N Z Vet J27:159–160, 165, 1979.Pier, A.C. Actinomycetes. In: Stoenner, H., W. Kaplan, M. Torten, eds. Vol 1, Section A:CRC Handbook Series in Zoonoses. Boca Raton: CRC Press; 1979.Smego, R.A., H.A. Gallis. The clinical spectrum of Nocardia brasiliensis infection in theUnited States. Rev Infect Dis 6:164–180, 1984.