Ann Dermatol.  2008 Jun;20(2):82-85. 10.5021/ad.2008.20.2.82.

A Case of Disseminated Nocardiosis Secondary to the Skin Nodules in an Elderly Woman

• In SG
• Han SH
• Shin JH
• Choi GS
• Chung MH

• KMID: 2172090
• DOI: http://doi.org/10.5021/ad.2008.20.2.82

Abstract

Nocardiosis refers to a locally invasive or disseminated infection associated with the Nocardia species. Most infections enter through the respiratory tract and then disseminate systemically. Rarely can a primary nocardial infection of the skin spread to contiguous structures or disseminate to other internal organs in immunocompromised hosts. We describe a 70-year-old woman who suffered from recurrent nodular skin lesions on her right hand, forearm and elbow following inoculation of a traumatic injury. Analysis of the purulent exudates obtained from the nodule revealed Nocardia species. After 20 days, a chest X-ray showed newly developed multiple nodules in both lungs. The diagnosis of systemic nocardiosis was established, and we treated this case with trimethoprim-sulfamethoxazole.

Keyword

Disseminated nocardiosis; Nocardia; Nocardiosis

MeSH Terms

Aged
Elbow
Exudates and Transudates
Female
Forearm
Hand
Humans
Immunocompromised Host
Lung
Nocardia
Nocardia Infections
Respiratory System
Skin
Thorax
Trimethoprim, Sulfamethoxazole Drug Combination
Nocardia Infections
Trimethoprim, Sulfamethoxazole Drug Combination

Figure

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  Fig. 1 Multiple erythematous nodules on the right forearm (A) and the dorsum of hand (B).

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  Fig. 2 Granulomatous inflammation with central suppurative inflammation (A: H&E, ×40; B: H&E, ×400).

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  Fig. 3 Newly developed multiple nodules in both lungs.

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  Fig. 4 (A) Whitish, wrinkled, heaped up colonies on potato dextrose agar plate cultured for 43 days. (B) Gram stain showed gram-positive branching organisms (×100).

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