Lymphocutaneous nocardiosis caused by Nocardia brasiliensis in an immunocompetent patient: a case report

Abstract

Nocardia usually manifests as opportunistic infections in immunocompromised hosts. Here, we report a rare case of an immunocompetent patient with lymphocutaneous nocardiosis. The patient was a 34-year-old man presenting with fever, multiple scattered pustules on both upper limbs and several subcutaneous nodules on the left elbow and forearm. Skin biopsy of the subcutaneous nodule revealed suppurative inflammation of the lymph nodes. Pus cultures were finally identified as Nocardia brasiliensis. The patient fully recovered without relapse after receiving optimized antimicrobial therapy consisting of linezolid combined with sulfonamides. Nocardiosis is a rare opportunistic disease which may be fatal and usually affects immunocompromised hosts, resulting in suppurative and granulomatous inflammation. Nocardia has a long culture cycle, is difficult to diagnose, and is more likely to be neglected in healthy young people. The present case suggests that physicians should be aware that nocardiosis is a differential diagnosis to consider in patients with suppurative infection, especially when anti-infective treatment is ineffective.

Severe disseminated Nocardia brasiliensis pneumonia with normal immune function: A case report

“…Another noteworthy problem is that the patient skin nodules are cold abscesses, without fever, redness, fever, obvious pain or inflammation. This finding is similar to that of Li Siying et al [ 12 ] And Alison M. Fernandes et al [ 13 ] Consistent with the findings of Ana María Medina-Torres et al [ 14 ] This suggests that when cold pus appears in soft tissues such as the lower limbs, neck, nose, scalp, etc., Basinocardium infection cannot be ruled out.…”

Nocardia Lymphadenitis and Encephalitis in Immunocompromised Patient: A Case Report

“…Nocardia may inoculate directly via the skin and abscess or local cellulitis can be formed after skin infection. Once it has reached regional lymph nodes, it may form multiple erythematous nodules along the lymphatic tract, called lymphocutaneous nocardiosis [10]. In this case, the patient may have risk factors as a farmer.…”

Molekularni probir Nocardia spp. u divljih sisavaca - presječna studija

“…Nocardiosis is an emergent granulomatous zoonosis that until the early 21 st century was considered a rare opportunistic disease and only a clinical curiosity (Corti and Villafane-Fioti, 2003;Rodrigues et al, 2009;Li et al, 2020). In fact, nocardiosis typically manifests as an opportunistic disease, with 60% of affected patients having immunosuppressive conditions, though infection may also develop in immunocompetent patients.…”