Nocardial Infections in Renal Transplant Recipients

Upon review of the English literature and the patients at our hospital, we identified 94 renal transplant recipients with nocardiosis. These patients were further evaluated and compared to nonrenal transplant patients with nocardiosis. We found that these patients were similar in presentation, course, and therapeutic outcome to non-transplant patients. Survival was related to underlying disease, site of infection, rapidity with which the diagnosis was made and, especially, the inclusion of a sulfa compound in the antimicrobial regimen. Transplant centers with high rates of Nocardia infection should consider trimethoprim/sulfamethoxazole prophylaxis for at least the first year after transplantation.