• Actinomyces and Nocardia are the fungus-like bacteria
    • they grow in branching structures (mycelia)
    • they are water and soil saprophytes
    • both are gram-positive rods
  • Actinomyces form sulfur granules and are anaerobic
  • Nocardia are acid-fast (partially) and aerobic
  • Treat with "SNAP"
    • Sulfa for Nocardia
    • Actinomyces use Penicillin
Nocardia    Actinomyces

Culture requirements
  • Aerobic
  • Anaerobe
  • Partially acid-fast
  • Not acid-fast


  • Soil
  • Commensal of mouth genital and GI tracts
Clinical presentation
  • Pulmonary infections in immunocompromised
  • Cutaneuous infections in immunocompetent following trauma
  • Multiple brain abscesses
  • Cervico-facial abscesses which drain through sinus tracts forming yellow sulfur granules
  • PID with IUDs
  • Solitary brain abscess

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