Progress on the diagnosis and treatment of nocardiosis in organ transplant recipients

Nocardiosis is a collective term for tissue and organ damage caused by Nocardia infection. Solid organ transplant recipients (SOTR) are at an increased risk of various pathogen infections, including Nocardia infection, due to immunosuppressive therapy which weakens their immune function. The diagnosis of nocardiosis has been challenging in the past. With the advent of molecular biology and other diagnostic methods, the diagnostic rate has significantly improved. Nocardia not only prone to cause necrotic pulmonary lesions but also invade other organs and tissues, such as intracranial infections and skin soft tissue infections, and can develop into systemic disseminated infections. For SOTR, nocardiosis is a potentially fatal disease with a fatality as high as 30%. Therefore, this article reviews the clinical characteristics of common nocardiosis in SOTR, new diagnostic technologies, and different anti-infective treatment strategies, aiming to provide a reference for the prevention and treatment of nocardiosis in clinical SOTR.