Introduction 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 Characteristics Nocardia Actinomyces Culture requirements Aerobic Anaerobe Stain Partially acid-fast Not acid-fast Reservoir 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