180.2 📚 國考版

180.2.0.1 必背 — Nocardia vs Actinomyces 鑑別 (考點)

項目 Nocardia Actinomyces
O2 Aerobic Anaerobic
Modified AFB + -
Source Soil inhalation Endogenous mucosal
Host Immunocompromise Healthy + mucosal breach
Sulfur granules No Yes
First-line Tx TMP-SMX ± combo Penicillin / Amox
Course 6-12 mo 6-12 mo

180.2.0.2 必背 — Nocardia 高 risk

  • 移怍, chronic steroid, HIV (low CD4), TNF-blocker, chemo
  • Pulmonary + brain abscess most common combination

180.2.0.3 必背 — Brain abscess in immunocompromise — 考 Nocardia

180.2.0.4 必背 — Actinomyces — “Lumpy jaw” (cervicofacial) + IUD pelvic

180.2.0.5 必背 — Sulfur granules = Actinomyces

180.2.0.6 必背 — N. farcinica 抗藥

(可胜 resist imipenem, ceftriaxone, broader treatment)