Breast Abscess by Nocardia

Simbula, Luca; Meloni, Giovanni Battista; Sanna, Silvana; Becchere, Maria Paola; Dessole, Salvatore; Cherchi, P; Capobianco, Giampiero

doi:10.1111/tbj.12064

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“…Puncture or other contaminated traumatic inoculum, such as thorn, insect or animal bite, scratch, bullet injury, intravenous drug abuse [9,19,47,48]. Occupation like farmer, shepherd, gardener, and an history of rural background or barefoot walking may help in typical pedal mycetoma, but unusual site are also to be considered, such as the face, neck, breast, back or even the scalp, after a car incident, and the vulva simulating an advanced carcinoma [31,[49][50][51][52].…”

Section: Considering the Necessity Of A Port Of Entry Main Risks Facmentioning

confidence: 99%

Cutaneous Nocardiosis

Atzori¹

2014

SOJ Microbiol Infect Dis

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Open Access Review Article cutaneous inoculation. Primary cutaneous nocardiosis is more common, with incidence rates ranging from 5% to 24% in various countries like India, UK, and Spain [10-12]. A major problem is correct identification, as clinical presentation is not peculiar as well as histological findings, suggestive of an infective process, but not able to detect the microorganisms, unless a tissue culture has been performed and Gram stained. The laboratory should be advised of the clinical suspicion, as Nocardia is a slow-growing bacterium, and cultures are often discarded when no growth is seen within 48 hours, or obscured by rapidly growing bacteria [1]. Once the Nocardiosis is presumed, speciation might take 1-3 weeks, and each strain has individual antibiotic susceptibility pattern, conditioning empiric treatment and possible fatal course. Newer molecular technologies promise to provide rapid and accurate identification [13], but first of all have revolutionized taxonomy, and we have to face with currently more than 30 species. Clinical relevance has been determined for about seventeen species [14,15] in respect to the 4 pathogens identified by traditional hydrolysis patterns: N. asteroides, N. brasiliensis, N. otitidiscaviarum, and N. transvalensis. Distinct serotypes and biotypes might share the same antibiotic susceptibility profile [8,13-18]. In western Europe and USA, the term "N.asteroides complex" is frequently used, failing to differentiate the strain cluster (N.asteroides sensu strictu) from N. cyriacigeorgica, N. farcinica, N. nova, N. abscessus, Nocardia brasiliensis, which is the second most common isolates in the majority of countries [14,16], differs from N.pseudobrasiliensis in mycolic acid pattern, adenine decomposition, nitrate reduction, and antimicrobial agent susceptibilities [18] For all these issues, clinical management and treatment of patients with nocardial disease remain a challenge. This review characterizes the cutaneous manifestations and related risk factors, to suggest clues in clinical diagnosis, raise physicians alert to avoid delayed recognition and address the correct assessments. Skin manifestations From a general health perspective, cutaneous nocardiosis (CN) traditionally occurs with 3 main patterns: (1) actinomycetoma, (2) lymphocutaneous (sporotrichoid) infection, (3) superficial skin infection (Table 1). Some classification adds a distinct 4 th pattern, corresponding to the secondary skin

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Section: Considering the Necessity Of A Port Of Entry Main Risks Facmentioning

confidence: 99%

Cutaneous Nocardiosis

Atzori¹

2014

SOJ Microbiol Infect Dis

View full text Add to dashboard Cite

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Breast Abscess by Nocardia

Cited by 1 publication

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Cutaneous Nocardiosis

Cutaneous Nocardiosis

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