Nocardia asteroides, direct gram smear.

Nocardia is one of the branching beaded gram positive bacteria and is very slow growing and won’t be detected in culture. Once we see suspect organisms in the direct smear, we do a modified acid fast stain (below), and we move right into notification of the physician. This is because it rapidly disseminates from the lungs to form brain abscesses and is very difficult to treat (long term, multidrug therapy).

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    Fabulous timing for this post! I spotted a...blood culture Gram

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    I feel it’s weird to have favourites among bacteria, seeing as most...all. I suppose...

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