THE PREVALENCE OF NOCARDIOSIS IN AN AREA OF ENDEMIC TUBERCULOSIS

This is a prospective study recruiting 120 patients successively who w ere admitted to the chest department in hospital for respiratory infec tions irrespective of their aetiology. The aim of the study was to ass ess the frequency of nocardiosis in respiratory pathology in the era o f AIDS and in an area where tuberculosis is endemic. The HIV serology was carried out on all 120 patients. A systemic search was made for no cardiosis and Koch's bacillus in the sputum and also in the broncho-al veolar lavage liquid obtained by endoscopy. The HIV serology was posit ive in 74 patients (61.7%). Pulmonary nocardiosis was diagnosed in fiv e patients (4.2%), of whom four patients were HN positive (80%). Tuber culosis was diagnosed in 58 cases (48.3%) of whom 40 were HIV positive (70%). The association of nocardiosis and tuberculosis was present in only one patient. The radioclinical aspect of nocardiosis in our serv ice was suggestive of tuberculosis. The prevalence of nocardiosis in o ur series at 4.2% is in agreement with that obtained in autopsy studie s in the Ivory Coast. The similarity of the radioclinical appearance b etween tuberculosis and nocardiosis demands that a search is made for the latter on all HIV positive patients and in negative cases a search for Koch's bacillus and empirical antibiotic therapy ought to have a spectrum of activity that would include nocardia.