此前有报道美国诺卡菌病的发病率估计每年500~1000例。[1]Beaman BL, Burnside J, Edwards B, et al. Nocardial infections in the United States, 1972-1974. Infect Dis. 1976;134:286-289.http://www.ncbi.nlm.nih.gov/pubmed/789786?tool=bestpractice.com然而,由于近年免疫抑制患者数量增加,诺卡菌病的发病率也在增加。全球各种族和各年龄段都有诺卡菌病报道,男性发病率是女性的2~3倍。[2]Yildiz O, Alp E, Tokgoz B, et al. Nocardiosis in a teaching hospital in the Central Anatolia region of Turkey: treatment and outcome. Clin Microbiol Infect. 2005;11:495-499.http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2005.01145.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/15882201?tool=bestpractice.com[3]Matulionyte R, Rohner P, Uçkay I, et al. Secular trends of nocardia infection over 15 years in a tertiary care hospital. J Clin Pathol. 2004;57:807-812.http://jcp.bmj.com/content/57/8/807.longhttp://www.ncbi.nlm.nih.gov/pubmed/15280400?tool=bestpractice.com肺部疾病是最常见的临床表现(约50%的病例),大多数病原菌来自以前的复合星形诺卡菌感染。[4]Hui CH, Au VW, Rowland K, et al. Pulmonary nocardiosis re-visited: experience of 35 patients at diagnosis. Respir Med. 2003;97:709-717.http://www.ncbi.nlm.nih.gov/pubmed/12814159?tool=bestpractice.com肺诺卡菌患者约三分之一会发展为播散性诺卡菌病。[5]Yildiz O, Doganay M. Actinomycoses and Nocardia pulmonary infections. Curr Opin Pulm Med. 2006;12:228-234.http://www.ncbi.nlm.nih.gov/pubmed/16582679?tool=bestpractice.com[6]Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006;19:259-282.http://cmr.asm.org/content/19/2/259.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16614249?tool=bestpractice.com实体器官移植受者诺卡菌感染发生率在0.4%~3%之间,且感染多为心脏、肾脏、肝脏和肺移植受者。[7]Husain S, McCurry K, Dauber J, et al. Nocardia infection in lung transplant recipients. J Heart Lung Transplant. 2002;21:354-359.http://www.ncbi.nlm.nih.gov/pubmed/11897524?tool=bestpractice.com[8]Santos M, Gil-Brusola A, Morales P. Infection by Nocardia in solid organ transplantation: thirty years of experience. Transplant Proc. 2011;43:2141-2144.http://www.ncbi.nlm.nih.gov/pubmed/21839216?tool=bestpractice.com[9]Clark NM, Reid GE; AST Infectious Diseases Community of Practice. Nocardia infections in solid organ transplantation. Am J Transplant. 2013;13(suppl 4):83-92.http://www.ncbi.nlm.nih.gov/pubmed/23465002?tool=bestpractice.com骨髓移植受者诺卡菌病的发病率约为普通人群的340倍。[10]Filice GA. Nocardiosis in persons with human immunodeficiency virus infection, transplant recipients, and large, geographically defined populations. J Lab Clin Med. 2005;145:156-162.http://www.ncbi.nlm.nih.gov/pubmed/15871308?tool=bestpractice.com原发性皮肤诺卡菌病是一种罕见的疾病,与免疫功能正常患者的直接接种有关,通常由巴西诺卡菌引起。[6]Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev. 2006;19:259-282.http://cmr.asm.org/content/19/2/259.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16614249?tool=bestpractice.com[11]Satterwhite TK, Wallace RJ Jr. Primary cutaneous nocardiosis. JAMA. 1979;242:333-336.http://www.ncbi.nlm.nih.gov/pubmed/376887?tool=bestpractice.com[12]Inamadar AC, Palit A. Primary cutaneous nocardiosis: a case study and review. Indian J Dermatol Venereol Leprol. 2003;69:386-391.http://www.ijdvl.com/article.asp?issn=0378-6323;year=2003;volume=69;issue=6;spage=386;epage=391;aulast=Inamadarhttp://www.ncbi.nlm.nih.gov/pubmed/17642947?tool=bestpractice.com[13]Fukuda H, Saotome A, Usami N, et al. Lymphocutaneous type of nocardiosis caused by Nocardia brasiliensis: a case report and review of primary cutaneous nocardiosis caused by N. brasiliensis reported in Japan. J Dermatol. 2008;35:346-353.http://www.ncbi.nlm.nih.gov/pubmed/18578712?tool=bestpractice.com[14]Ambrosioni J, Lew D, Garbino J. Nocardiosis: updated clinical review and experience at a tertiary center. Infection. 2010;38:89-97.http://www.ncbi.nlm.nih.gov/pubmed/20306281?tool=bestpractice.com