Primary Lymphocutaneous <i>Nocardia brasiliensis</i> in an Immunocompetent Host: Case Report and Literature Review

<i>Nocardia</i> spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestat...

Full description

Bibliographic Details
Main Authors: Igor Dumic, Alethea Brown, Kyle Magee, Sammer Elwasila, Marija Kaljevic, Marina Antic, Oladapo Igandan, Milena Cardozo, Libardo Rueda Prada, Margaret Paulson
Format: Article
Language:English
Published: MDPI AG 2022-03-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/58/4/488
Description
Summary:<i>Nocardia</i> spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestations of cutaneous disease are varied and frequently misdiagnosed. We present a case of an immunocompetent 66-year-old man who sustained a left finger injury while gardening. He was misdiagnosed on several occasions and treated with inappropriate antibiotics against <i>Streptococcus</i> spp. and <i>Staphylococcus</i> spp. When infection spread cutaneously, sporotrichoid (lymphocutaneous) nocardiosis was suspected and the patient was started on appropriate therapy with Bactrim which resulted in a cure. We also summarize the literature on lymphocutaneous infection by <i>Nocardia brasiliensis</i>. By reporting this case, we want to raise awareness among clinicians about unusual causes of cellulitis, the differential diagnosis of lymphocutaneous infection and the importance of obtaining a detailed exposure history to assist in the prompt diagnosis of nocardiosis.
ISSN:1010-660X
1648-9144