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Background: Infections caused by Nocardia are rare, but misguided to clinicians, especially if there is a delay in the diagnosis and/or low response to chemotherapy. The incidence of nocardiosis is increasing constantly worldwide, and the situation is getting worse if we consider immunocompromised individuals, such as human immune virus (HIV) positive patients since they are at higher risk. Surgical amputation, although not common, but should be considered as a result in some cases that cause partial disability., Aims: To throw light on the situation of nocardiosis in Sudan, the possible reasons for the increased prevalence are investigated and discussed the possible strategies for prevention and control. Data Review: PubMed investigations were adopted using terms that included nocardiosis in Sudan as well as in other parts of the world. Part of the review has been retrieved from the main library of the postgraduate college, University of Khartoum and University of Newcastle upon Tyne., Findings: In Sudan, nocardiosis revealed wide geographical distribution; different cases were reported from western, middle as well as the northern parts of the country. Moreover, several clinical presentations were seen. While pulmonary, coetaneous and subcutaneous infections represent the primary types caused by Nocardia, disseminated infection in two or more organs had also been reported. As in all other infectious diseases, opportunistic nocardiosis is more prevalent among HIV patients. Zoonotic transmission of the disease was also proved; several cases of bovine and caprine mastitis were due to one or another species of Nocardia. The effect of ecology on the prevalence and pathogenicity of Nocardia is proved by the isolation of Nocardia and other actinomycetes from Sudanese soil, which represents the most probable source of infection. Regarding treatment, effective results are usually obtained by the use of sulfonamides and thirdgeneration cephalosporins. However, surgical interference is also used when necessary, such as in cases of drainage of abscesses., Conclusion: Since the description of Nocardia by Edmond Nocard in 1888, it started to be well known worldwide. In Sudan, however, the awareness regarding this bacterium is still below the level and is only due to the end of the fifties of the twentieth century, which is relatively late. Hence, attention towards this neglected pathogen may lead to early recognition and prompt treatment, resulting in complete cure., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Fifteen of 100 mastitic milk samples from goats suffering from mastitis were tentatively identified as members of the genus Nocardia on the basis of selected phenotypic and chemotaxonomic characteristics. Six of the 155 strains were confirmed as Nocardia farcinica by 16S rDNA gene sequencing and subsequent aligning with relevant actinomycetes found in electronic databases and 2 by other identification criteria. N. farcinica is a serious cause of mastitis with a significant prevalence (15%) among the examined goats. Efforts are needed to optimise and simplify isolation and identification methods.

Objective: To determine the aetiological types of granulomatous disease of the breast in women presenting with mammary complaints in the Sudan., Methods: Clinical history and physical examination, complete blood counts, Mantoux test, histopathology and fine needle aspiration cytology (FNAC)., Results: Granulomatous mastitis was seen in 11/2500 (0.44%) patients with mammary disease over a 10-year period. All were of childbearing age (mean 26.0 +/- 5.9 years). Common presentations were diffuse swelling, well-circumscribed masses, nipple retraction, multiple sinuses and superficial skin ulcers. Lymphadenopathy was seen in more than 60% of the patients. Diagnosis was based on cytomorphological features in 10/11 cases and histopathology in one. Nine were diagnosed with tuberculous mastitis and two with idiopathic granulomatous mastitis. Acid-fast bacilli (AFB) could not be demonstrated in any of the cytology smears. Tuberculous mastitis responded to empirical anti-tuberculosis treatment, with a minimum follow-up of 2 years in seven women., Conclusion: Tuberculous mastitis is a rare entity in women with mammary disease in the Sudan. Alternative diagnoses such as idiopathic granulomatous mastitis should be made only after failure of an adequate trial of anti-tuberculosis treatment. FNAC is a useful diagnostic tool even if AFB cannot be demonstrated.

Seven hundred and sixty-three camels from 400 herds of local Sudanese camel breeds were investigated for the prevalence of mastitis, identification of its bacterial causes and determination of the leucocyte contents of camel's milk. One hundred and forty-nine (19.5 per cent) of the 763 camels examined were diagnosed as mastitis cases based on clinical signs. One hundred and fifty-nine (47.3 per cent) of the 336 randomly selected milk samples were reactive in a rapid mastitis test and 16 of the 153 tested samples contained Brucella abortus agglutinating antibodies. Streptococcus, Staphylococcus, Micrococcus and Aerobacter species and Escherichia coli were found to be the main causes of mastitis (in descending order). The leucocyte contents of the 757 milk samples ranged from < 5 x 10(5) to > 7.5 x 10(6) leucocyte ml-1 and 42.8 per cent of the samples contained < 5 x 10(5) cells ml-1. Neither significant correlation between the leucocyte content of milk and isolated bacterial species nor significant variation in leucocyte contents during different stages of lactation were detected.