Dear Doctor: What is nocardiosis and do I have to get rid of my 28 houseplants?


OregonLive 01 July, 2021 - 10:08am 53 views

DEAR DR. ROACH: I was just diagnosed with nocardiosis. Not knowing anything about it, I started to do some research and, like in most cases, going to the internet really didn’t help. My pulmonary doctor didn’t tell me much except to put me on sulfamethoxazole drugs.

I reacted poorly and was switched to minocycline. Are there any diet changes I should be aware of, or life changes? Should I get rid of the 28 houseplants I have in my apartment?

I was surprised to find a group page on social media. It is more widespread than I was aware of, but there seems to be very little information on the harmful effects and guidelines to follow.

I would appreciate any information regarding this disease and what to expect and signs of getting better or worse. -- M.D.G.

ANSWER: Nocardia is a genus of bacteria that is an unusual cause of infection. Lung and skin are the most common sites of infection, but it may also affect the brain or become widely spread throughout the body. Most people with nocardia infection have weakened immune systems, such as by HIV, diabetes, cancer or drugs that suppress the immune system. About a third of cases occur in people with no identifiable immune system disease. Far more men than women are affected by nocardia. Symptoms of lung infection are nonspecific and may include cough, fever, weight loss, shortness of breath and night sweats.

Lung infections are most acquired by inhaling dust containing the organism. Nocardia is found in the soil, and houseplants are known sources of the infectious soil. It’s possible that one of your plants contained the bacteria. Still, I think that getting rid of all your plants is probably unnecessary. I would recommend an N95 mask if you are repotting or gardening outside.

Treatment of nocardia of the lung in people with normal immune systems usually involves trimethoprim and sulfamethoxazole; since that seemed not to do well for you, minocycline is a reasonable option. Your immune system is going to be doing much of the work, aided by the antibiotics, so you can help your immune system by sleeping well, avoiding excess alcohol and eating a generally healthy diet.

Recurrence or failure of your symptoms to get better would be a reason to consider changing therapy. An infectious disease doctor may be an additional resource along with your pulmonary specialist.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to or send mail to 628 Virginia Dr., Orlando, FL 32803.

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