Hello Jmanna,
In most cases, your doctor would refer you to an infectious disease
specialist. You make it sound as if your doctor is not treating you as
you feel s/he should! Your best course of action would be to see your
doctor for a referral to an infectious disease specialist.
Another route would be for your doctor to consult with an infectious
disease specialist. Its best for the doctors speak together, as your
doctor knows your condition and can better understand what the ID
specialist recommends. Your doctor can then treat you per the ID
specialist's recommendations. It?s highly doubtful an ID specialist
would treat you without a referral, seeing you and having a copy of
your records.
I am posting some hospitals with excellent infectious disease
specialists, whom your doctor can contact for a consult, but chances
are your doctor is already familiar with an ID specialist or a medical
center that handles infectious diseases. Your doctor may also call the
CDC or your state?s Public Health Department for recommendations on
Nocardia treatment.
?Not everyone who has an infectious disease needs an infectious
disease specialist. Your general internist can take care of most
infections, but sometimes specialized expertise is needed to either
diagnose or manage specific infectious diseases.?
?Although infectious diseases specialists sometimes serve as primary
care physicians, in most cases you will still need your regular
doctor. Usually you will be asked to return to the ID specialist for a
follow-up visit to review test results and to be sure that your
infection has been eliminated. ID specialists may wish to follow up
with you until we feel confident that the infection will not recur.
You will resume care with your regular physician when your condition
has stabilized or is cured.?
http://www.doctorsforadults.com/subspec/dfa_infe.htm
About Nocardia
===============
?Treatment
Long-term antibiotic therapy (usually with sulfonamides) for 6 months
to a year (or longer depending on the individual and site involved) is
needed to treat nocardia. Frequently, chronic suppressive therapy may
be needed (prolonged, low-dose antibiotic therapy).
In addition, in patients with abscesses caused by this infection,
surgery may be required in order to ensure adequate drainage.
Expectations (prognosis)
Prognosis depends on the sites involved. There is a significant
mortality rate if more than 1 site is involved (disseminated
nocardiosis). In addition, the degree of impairment of the
individual's immune system will affect the outcome.?
http://www.doctorsforadults.com/subspec/dfa_infe.htm
?A 56-year-old diabetic woman developed multiple cutaneous lesions and
septic arthritis secondary to disseminated Nocardia asteroides
pulmonary infection. The diagnosis was made rapidly by Gram's and
acid-fast stains of pus, sputum, and synovial fluid and later
confirmed by cultures. Sulfonamides are the drugs of choice for
nocardiosis, and this patient had a complete response to two weeks of
intravenous trimethoprim and sulfamethoxasole followed by three months
of oral therapy.?
http://archderm.ama-assn.org/cgi/content/abstract/121/7/898
?The optimal therapy for infections due to Nocardia species has not
been established. To assess the efficacy of
trimethoprim-sulfamethoxazole (TMP-SMX), we reviewed the records of 19
patients with Nocardia infections seen at Duke University Medical
Center, Durham, NC, who were treated with this drug, either alone or
in combination with other antibiotics or a surgical procedure.
Underlying diseases or therapy causing immunosuppression were present
in all but five cases. Sites of involvement were lung (ten of 19),
wound (two of 19), and brain (two of 19); five of 19 patients had
disseminated disease. The mean duration of therapy was 7.2 months.
Overall cure or improvement was achieved in 89% (17/19) of cases; 80%
of patients with disseminated disease and 60% of those with CNS
involvement recovered. This experience, and accumulated clinical
evidence in the literature, indicates that TMP-SMX should be
considered the therapeutic drug of choice in infections due to
Nocardia species.?
http://archinte.ama-assn.org/cgi/content/abstract/143/4/711
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/nocardiosis_t.htm
Infectious Diseases Societies
=============================
Here is a state list of Infectious Disease Societies. You can call the
number closest to your home and request a list of specialists in your
area. http://www.idsociety.org/Content/NavigationMenu/About_IDSA/State_and_Regional_Societies/Links_to_State_andamp;_Other_Affiliated_ID_Societies.htm
Duke University Medical Center
==============================
Duke University is in the top 20 hospitals for treating infectious disease.
Infectious Diseases Division Office
Phone: (919) 684-2660
Fax: (919) 684-8902
For Appointments call
Phone: (919) 668-3190
John Bartlett is an energetic, very caring, and friendly doctor who
specializes in infectious diseases, and also HIV and immunocompromised
patients.
You can be assured that you and your doctor will be referred to a
specialist who is knowledgeable about Nocardia species infections, at
Duke University Medical Center.
http://infectiousdisease.duke.edu/home.asp?divisionID=50
Staff
http://infectiousdisease.duke.edu/staffList.asp?divisionID=50
Cleveland Clinic
=================
?Please note: If this matter is of an urgent nature, please contact
your primary physician or go to your local emergency room. If you are
not sure of the urgency of your problem, feel free to contact
Cleveland Clinic Nurse on Call (in Cleveland) toll free at
(866)263-4029 Monday through Friday 8 a.m. to 11 p.m. EST, to speak
with a Registered Nurse, who will help you determine the urgency of
your problem.?
http://www.clevelandclinic.org/quality/outcomes/infectiousDisease/
To make an appointment/consult
http://www.clevelandclinic.org/myappointment/
University of California, SF
============================
University of California, San Francisco
University of California at San Francisco
School of Medicine
Department of Medicine
Division of Infectious Diseases
521 Parnassus Avenue
C-443, Box 0654
San Francisco, CA
94143-0654
idoffice@medicine.ucsf.edu
(415) 476-9362
http://medicine.ucsf.edu/id/index.html
Faculty
http://medicine.ucsf.edu/id/idfaculty.html
University of Michigan
=======================
University of Michigan
Division of Infectious Diseases
Department of Internal Medicine
University of Michigan Medical Center
1500 East Medical Center Drive,
3119 Taubman Center
Ann Arbor, MI 48109-0378
Ph. 734-936-5205 / Fax 734-936-2737
?Division of Infectious Diseases
The Division of Infectious Diseases at the University of Michigan was
founded in 1958. Since then, the division has become recognized
nationally for an exemplary record of patient care, research and
teaching.
Infectious Diseases is the medical specialty concerned with the
diagnosis and treatment of a variety of infectious problems including
chronic viral diseases, sexually transmitted diseases, chronic
mononucleosis, chronic bone and joint infections, endocarditis,
chronic urinary tract infections, and chronic infections occurring
with diabetes mellitus.
In addition to the regular Infectious Diseases Outpatient Service, an
Immunization and Overseas Travel Consultation Service is available for
consultation, general health advice, and immunizations for both
domestic and international travel.?
http://www.med.umich.edu/intmed/infectious/
I hope this answer has been helpful to you. If not, please request an
Answer Clarification, before rating. This will allow me to assist you
further on this answer.
Sincerely, Crabcakes
Search Terms
=====================
Nocardia infections
Infectious disease + specialists
Duke University + Infectious diseases
Cleveland Clinic + Infectious diseases
Tropical medicine + Nocardia |
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