Unusual bacteria targets weak immune systems

Dear Dr. Roach: I was diagnosed with nocardiosis. 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?

I was surprised to find a group page on social media.

I would appreciate any information regarding this and what to expect. — M.D.G.

Dear M.D.G.: Nocardia is a genus of bacteria that is an unusual cause of infection. Lung and skin are the most common sites of infection. Most with nocardia infection have weakened immune systems. Far more men than women are affected. Symptoms of infection are nonspecific and include cough, fever, weight loss, shortness of breath and sweats.

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

Treatment of nocardia of the lung in people with normal immune systems usually involves trimethoprim and sulfamethoxazole; 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 would be a reason to consider changing therapy. An infectious disease doctor may be a resource.