First Case of Nocardia pseudobrasiliensis Causing Primary Cutaneous Nocardiosis in an Immunocompetent Patient

Abstract

Nocardia brasiliensis is the most common cause of cutaneous nocardiosis. Nocardia pseudobrasiliensis is an emerging species responsible for invasive and disseminated disease in immunocompromised patients. We describe a case of a 67-year-old immunocompetent patient without significant past medical history diagnosed with primary cutaneous nocardiosis with N pseudobrasiliensis as the causative organism. In our opinion, we report the first case of primary cutaneous nocardiosis in an immunocompetent patient with N pseudobrasiliensis being the causative agent.

A Rare Case of a Subcutaneous Abscess Caused by Nocardia cyriacigeorgica in an Immunocompetent Patient

“…Nocardiosis has been recognized as an emerging communicable disease with an incidence rate of approximately 500–1000 cases in the United States every year, of which 60% are described in immunocompromised patients and about 10% are cutaneous in nature. 12 Approximately 80% of cutaneous nocardiosis are caused by Nocardia brasiliensis 13 ; thus we report the first case of a subcutaneous abscess caused by N. cyriacigeorgica in an immunocompetent patient in this area. Traumatic inoculation of skin by Nocardia brasiliensis progresses to cellulitis, nodules, impetigo, pyoderma, sporotrichosis-like lymphangitis, chronic pyogenic granuloma, multiple fistula or cutaneous involvement in hematogenous dissemination, mainly reported in patients with advanced AIDS and immunocompetent farmers with skin wounds, which were more common in the legs and feet, called mycetoma.…”

Epidemiology, clinicopathology, and diagnosis of cutaneous nocardiosis: A case series and population-level analysis

“…Multiple reports in the literature have noted the onset of primary cutaneous nocardiosis associated with direct soil inoculation in rural environments by way of hazards, including splinter injury, wasp sting, and other methods of skin trauma. 9 , 10 , 11 , 12 , 13 , 14 , 15 However, the majority of in-house and Health Facts database cases (84.2%, 587/697) occurred in urban (as opposed to rural) settings. Our findings suggest that certain urban exposures may be risk factors for primary cutaneous nocardiosis.…”

Erythema Nodosum following Nocardia Infection: A Case Report

“…We searched the PubMed database for case reports and case series studies on cutaneous nocardiosis in immunocompetent patients published between 2012 and 2022. Seven cases were retrieved [8][9][10][11][12][13][14]. Primary cutaneous nocardiosis caused by Nocardia is rare in immunocompetent patients.…”