Cat scratch responsible for primary cutaneous Nocardia asteroides in an immunocompetent patient

Nocardiainfections in cats: a retrospective multi‐institutional study of 17 cases

“…Direct smears from such material were stained using DiffQuik®, Burke's modification of the Gram stain (Figures 1, 2B) and occasionally a modified acid‐fast stain (Figure 2C). As Nocardia spp are only partially acid‐fast, the technique was modified, decolourising with 10% sulphuric acid for 3 to 5 minutes 73 . In some cases, tissue was fixed in formalin, embedded and stained using H&E (although Nocardia fail to take up this stain), Brown and Brenn's modification of the Gram stain and the ZN method.…”

“…Superficial nocardiosis following implantation is not necessarily associated with compromised cell‐mediated immunity, but may progress to disseminated disease in that setting. Nocardiae can establish infection following relatively trivial inoculation injuries, which may vary from insect bites and animal scratches, 73–76 to puncture wounds and contaminated abrasions. Since the initial response to Nocardia is pyogenic, skin lesions may initially be disregarded or treated as staphylococcal in origin.…”

Mycetoma of the Chest Wall due to Nocardia brasiliensis

“…Sulphonamides have been the mainstay of antimicrobial therapy for human nocardiosis (2). Although the optimal duration of therapy is uncertain, suggestions range from 6 weeks to one year (1,8,13,15). Other effective drugs include minocycline, dapsone, tetracycline, amikacin, amoxicillin-clavulanic acid, cefotaxime, imipenem, and rifanipicin.…”

“…Recently, new species including N. mexicana and N. vetet-atia were reported as causative agents of human mycetoma (5,6). The commonest predisposing event in all the reported cases of primary cutaneous nocardiosis is a local trauma caused by thorns or splinters or, less commonly, insect bites and cat scratches (7,8). The commonest predisposing event in all the reported cases of primary cutaneous nocardiosis is a local trauma caused by thorns or splinters or, less commonly, insect bites and cat scratches (7,8).…”

“…Cutaneous involvement with N. asteroides is usually secondary to haematogenous dissemination from a pulmonary focus. abscess, and cellulites (8)(9)(10). It is most commonly caused by N. brasiiiensis, typically affects immunocompetent individuals, and can be subdivided into 3 clinical entities, including: lymphocutaneous infection, mycetoma, and superficial skin infection, including ulcération.…”