Lymphocutaneous nocardiosis caused by Nocardia asteroides. Case report and literature review

Primary Cutaneous <i>Nocardia asteroides </i>Infection after Heart Transplantation

“…In our case, inoculation after insect bites was suspected, as recently described [13]. Cutaneous nocardiosis has often a deceptive clinical aspect with four kinds of lesions that can be associated together as in our patient: mycetoma [5], lymphocutaneous infection with sporotrichoid lesions [7, 9, 10, 11], abscess or cellulitis [1, 4, 7] and disseminated lesions. Lesions mimicking staphylococcal carbuncles have already been described once after renal transplantation [4].…”

Primary Cutaneous <i>Nocardia asteroides </i>Infection after Heart Transplantation

“…In our case, inoculation after insect bites was suspected, as recently described [13]. Cutaneous nocardiosis has often a deceptive clinical aspect with four kinds of lesions that can be associated together as in our patient: mycetoma [5], lymphocutaneous infection with sporotrichoid lesions [7, 9, 10, 11], abscess or cellulitis [1, 4, 7] and disseminated lesions. Lesions mimicking staphylococcal carbuncles have already been described once after renal transplantation [4].…”

Concurrent double infections of the skin: Phaeohyphomycosis and nocardiosis in a patient with idiopathic thrombocytopenic purpura

“…However, N brasiliensis has been isolated in most of the cases of lymphocutaneous nocardiosis in Japan, 3 probably because it is more virulent than N asteroides. 4,5 In our patient, the N asteroides isolated as the causal agent could be an opportunistic pathogen 6 associated with the immunosuppressed status of the patient.…”

Isolation of bothSporothrix schenckiiandNocardia asteroidesfrom a mycetoma of the forefoot

“…In the fixed variety, which accounts for about 15%, a dermal nodule develops that breaks down into a small ulcer, but the infection remains localized to one site. 7 Primary cutaneous nocardiosis can mimic sporotrichosis. 8 Most cases have a history of injury.…”

“… 12 Primary cutaneous N. asteroides infection can be cured by TMP–SMZ therapy, with reported periods until healing ranging from 6 months to several years, and with reported average success rates of > 60%. 13 The inital treatment with TMP–SMZ was done in accordance with the regimen applied by several authors, as TMP–SMZ has been used singly 1,2 , 5,7 , 8 and in combination with amicacin or streptomycin. 1 TMP–SMZ treatment is recommended in most reports from Southern and Central America with a therapeutic dose between 8 and 40 mg kg −1 daily.…”

Primary Cutaneous <i>Nocardia asteroides </i>Infection after Heart Transplantation

“…In our case, inoculation after insect bites was suspected, as recently described [13]. Cutaneous nocardiosis has often a deceptive clinical aspect with four kinds of lesions that can be associated together as in our patient: mycetoma [5], lymphocutaneous infection with sporotrichoid lesions [7, 9, 10, 11], abscess or cellulitis [1, 4, 7] and disseminated lesions. Lesions mimicking staphylococcal carbuncles have already been described once after renal transplantation [4].…”

Concurrent double infections of the skin: Phaeohyphomycosis and nocardiosis in a patient with idiopathic thrombocytopenic purpura

“…However, N brasiliensis has been isolated in most of the cases of lymphocutaneous nocardiosis in Japan, 3 probably because it is more virulent than N asteroides. 4,5 In our patient, the N asteroides isolated as the causal agent could be an opportunistic pathogen 6 associated with the immunosuppressed status of the patient.…”

Isolation of bothSporothrix schenckiiandNocardia asteroidesfrom a mycetoma of the forefoot

“…In the fixed variety, which accounts for about 15%, a dermal nodule develops that breaks down into a small ulcer, but the infection remains localized to one site. 7 Primary cutaneous nocardiosis can mimic sporotrichosis. 8 Most cases have a history of injury.…”

“… 12 Primary cutaneous N. asteroides infection can be cured by TMP–SMZ therapy, with reported periods until healing ranging from 6 months to several years, and with reported average success rates of > 60%. 13 The inital treatment with TMP–SMZ was done in accordance with the regimen applied by several authors, as TMP–SMZ has been used singly 1,2 , 5,7 , 8 and in combination with amicacin or streptomycin. 1 TMP–SMZ treatment is recommended in most reports from Southern and Central America with a therapeutic dose between 8 and 40 mg kg −1 daily.…”

Primary Cutaneous <i>Nocardia asteroides </i>Infection after Heart Transplantation

“…In our case, inoculation after insect bites was suspected, as recently described [13]. Cutaneous nocardiosis has often a deceptive clinical aspect with four kinds of lesions that can be associated together as in our patient: mycetoma [5], lymphocutaneous infection with sporotrichoid lesions [7, 9, 10, 11], abscess or cellulitis [1, 4, 7] and disseminated lesions. Lesions mimicking staphylococcal carbuncles have already been described once after renal transplantation [4].…”

Concurrent double infections of the skin: Phaeohyphomycosis and nocardiosis in a patient with idiopathic thrombocytopenic purpura

“…However, N brasiliensis has been isolated in most of the cases of lymphocutaneous nocardiosis in Japan, 3 probably because it is more virulent than N asteroides. 4,5 In our patient, the N asteroides isolated as the causal agent could be an opportunistic pathogen 6 associated with the immunosuppressed status of the patient.…”

Isolation of bothSporothrix schenckiiandNocardia asteroidesfrom a mycetoma of the forefoot

“…In the fixed variety, which accounts for about 15%, a dermal nodule develops that breaks down into a small ulcer, but the infection remains localized to one site. 7 Primary cutaneous nocardiosis can mimic sporotrichosis. 8 Most cases have a history of injury.…”

“… 12 Primary cutaneous N. asteroides infection can be cured by TMP–SMZ therapy, with reported periods until healing ranging from 6 months to several years, and with reported average success rates of > 60%. 13 The inital treatment with TMP–SMZ was done in accordance with the regimen applied by several authors, as TMP–SMZ has been used singly 1,2 , 5,7 , 8 and in combination with amicacin or streptomycin. 1 TMP–SMZ treatment is recommended in most reports from Southern and Central America with a therapeutic dose between 8 and 40 mg kg −1 daily.…”