Lab Test

Stain, Nocardia

Partial Acid Fast, Nocardia Stain, EPIC: LAB5529, SOFT: STNOR

Test Codes



  • Order a Fungal Culture, and indicate Nocardia as suspect agent, along with ordering a Nocardia Stain.
  • Fecal and urine specimens are inappropriate for testing.

Specimen Collection Criteria

Collect: Any of the following specimen types, placed in a sterile collection container:

  • Abscess fluid.
  • Bronchoalveolar Lavage (BAL).
  • Lung biopsy tissue.
  • Pulmonary secretions.
  • Sputum.
  • Tissue.
  • Transtracheal aspirates.
  • Subcutaneous tissue (less common).

Physician Office/Draw Specimen Preparation

Refrigerate (2-8°C or 36-46°F) specimens within two hours of collection. Maintain specimens refrigerated until transport.

Preparation for Courier Transport

Transport: Specimen in a sterile collection container, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

  • Dried material on a swab.
  • Urine or fecal specimens.
  • Frozen specimens.


Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 24 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 7 days


Grosse Pointe sent to Royal Oak Microbiology Laboratory for testing.
Royal Oak Microbiology Laboratory
Troy sent to Royal Oak Microbiology Laboratory for testing.


Monday – Friday, 7:00 am – 3:30 pm.
This test can be performed on weekends by request. 

Reference Range

No partially acid fast branching rods seen.

Test Methodology

Modified acid fast stain.


Knowledge of the presence of a Nocardia-like bacterium in a clinical specimen may provide information for antimicrobial therapy.

Clinical Utility

This assay aids in the diagnosis of nocardiosis.

Clinical Disease

Nocardiosis is caused by aerobic actinomycetes (Norcardia asteroides complex composed of N. abscessus, N. cyriacigeorgica, N. farcinica, N. nova, N. brasiliensis, and N. otitidiscaviarum). Norcardiosis is a chronic bacterial disease in immunocompetent persons, usually originating in the lungs, which may spread by the blood to produce abscesses of the brain, subcutaneous tissue and other organs. In immunocompromised persons, the case fatality rate is high. The frequent isolation of Norcardia asteroides complex from patients with other chronic pulmonary diseases may represent cases of a mild form of norcardiosis. These etiologic organisms also cause actinomycotic mycetomas. 

Microscopic examination of stained smears of sputum, pus or CSF reveals Gram-positive organisms with branching filaments that may be weakly acid-fast; culture confirms the identity of the organism. Biopsy or autopsy establishes involvment in causing disease (1).


Nocardiosis is an occasional sporadic disease that affects people and animals in all parts of the world. There is no evidence of age, sex, or racial differences (1).

Incubation Period

Uncertain; probably a few days to a few weeks (1).


It is found in the soil. Nocardia is not directly transmitted from humans to humans or from animals to humans (1).


  1. Chin, J. 2000. Control of Communicable Diseases Manual, American Public Health Association,Washington, D.C., pp. 362-363.
  2. Conville, P. S. & F. G. Witebsky. 2011. Nocardia, Rhodococcus, Gordonia, Actinomadura, Streptomyces, and Other Aerobic Actinomycetes*. In: Versalovic, J., et. al. (eds.). Manual of Clinical Microbiology. 10th edition. ASM Press. Washington, D.C., pp. 443-471.

CPT Codes



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This directory currently reflects information only for specimens collected and/or processed at the
Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.