Lymphocutaneous Nocardiosis Research Articles

Lymphocutaneous Nocardiosis in a Patient With Human Immunodeficiency/Tuberculosis Coinfection

Nocardia spp. are Gram-positive bacteria, which are acid-fast as well. Nocardiosis is characterized by abscess formation anywhere in the body, especially in the lungs, brain, and skin. The disease manifests as pulmonary disease, brain abscess, or disseminated lesions in immunocompromised individuals. However, skin involvement in the form of lymphocutaneous abscess is found in immunocompetent individuals. Nocardia spp. appear as thin, branched filaments in fine needle aspirate under the microscope. Diagnosis of the nocardiosis is done by fine needle aspiration cytology (FNAC) and identification through matrix-assisted laser desorption/ionization-time of flight mass spectrometry from aspirated materials. Our case is lymphocutaneous nocardiosis in a patient having human immunodeficiency (HIV)/tuberculosis coinfection.

Cutaneous nocardiosis with discharging sinus clinically mimicking tuberculosis diagnosed by cytology.

Nocardiosis is primarily a pulmonary infection commonly seen in immunocompromised individuals. However, lymphocutaneous nocardiosis is observed in immunocompetent individuals often after trauma. The clinical and cytomorphological features of lymphocutaneous nocardiosis closely mimic the most common infections in India such as tuberculosis and mycetoma (very common cutaneous infection with discharging sinus). As it is crucial to differentiate nocardiosis from tuberculosis, to avoid unnecessary antitubercular treatment, special stains like modified Ziehl-Neelsen stain and Gram stain can be employed to differentiate the morphology of Nocardia from tuberculosis. Fine-needle cytology from these cutaneous lesions helps in yielding adequate material for rapid and accurate diagnosis of immediate specific antibiotic treatment. We report a rare case that presented with clinical diagnosis of tuberculosis but turned out to be nocardiosis on cytomorphology with simple and most feasible fine-needle aspiration method of tissue diagnosis and scrape cytology.

Lymphocutaneous nocardiosis presenting as escharotic plaques in an immunocompetent patient

Lymphocutaneous nocardiosis presenting as escharotic plaques in an immunocompetent patient

Primary cutaneous nocardiosis in children

Introduction: Reports of paediatric cases of primary cutaneous nocardiosis are rare in Japan. We report the case of a 5-year-old immunocompetent boy with primary cutaneous nocardiosis. Case presentation: One week after injuring his left knee, the boy presented with fever, pain in the left hip joint and gait disturbance. Oral administration of cephalosporin proved ineffective, and he was not able to stand due to pain in the inguinal region. On admission, swelling of the left inguinal lymph nodes and abscess with microsatellite pustules in the left knee were found. Gram-positive bacilli with branching filaments grew in the culture from the drained pustule. They were partially acid fast on Ziehl–Neelsen staining. His symptoms improved after initiating treatment with sulbactam/cefoperazon and sulfamethoxazole/trimethoprim (TMP-SMX). Nocardia brasiliensis was identified from 16S rRNA gene sequencing. TMP-SMX was administered for 5 weeks, and no relapses have occurred as of the 1-year follow-up. Conclusion: N. brasiliensis lives in soil and is the major cause of primary lymphocutaneous nocardiosis. A cutaneous abscess with surrounding microsatellite lesions and lymphadenopathy suggest the possibility of cutaneous nocardiosis. Because growth of Nocardia spp. is very slow, adequate incubation time is necessary.

The Case Files

The Case Files

Lymphocutaneous nocardiosis caused by Nocardia brasiliensis in an immunocompetent elderly woman

International Journal of DermatologyVolume 55, Issue 1 p. e45-e47 Correspondence Lymphocutaneous nocardiosis caused by Nocardia brasiliensis in an immunocompetent elderly woman Sivan Sheffer MD, Sivan Sheffer MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorRony Shreberk-Hassidim MD, Rony Shreberk-Hassidim MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorKaren Olshtain MD, Karen Olshtain MD Department of Microbiology and Infectious Diseases, Jerusalem, IsraelSearch for more papers by this authorAlexander Maly MD, Alexander Maly MD Department of Pathology, Hadassah–Hebrew University Medical Center, Jerusalem, IsraelSearch for more papers by this authorAbraham Zlotogorski MD, Abraham Zlotogorski MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorYuval Ramot MD, MSc, Yuval Ramot MD, MSc [email protected] Department of Dermatology, Jerusalem, IsraelSearch for more papers by this author Sivan Sheffer MD, Sivan Sheffer MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorRony Shreberk-Hassidim MD, Rony Shreberk-Hassidim MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorKaren Olshtain MD, Karen Olshtain MD Department of Microbiology and Infectious Diseases, Jerusalem, IsraelSearch for more papers by this authorAlexander Maly MD, Alexander Maly MD Department of Pathology, Hadassah–Hebrew University Medical Center, Jerusalem, IsraelSearch for more papers by this authorAbraham Zlotogorski MD, Abraham Zlotogorski MD Department of Dermatology, Jerusalem, IsraelSearch for more papers by this authorYuval Ramot MD, MSc, Yuval Ramot MD, MSc [email protected] Department of Dermatology, Jerusalem, IsraelSearch for more papers by this author First published: 16 October 2015 https://doi.org/10.1111/ijd.12988Citations: 6Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume55, Issue1January 2016Pages e45-e47 RelatedInformation

Lymphocutaneous nocardiosis caused by Nocardia otitidiscaviarum: A case report and review of literature

Nocardia otitidiscaviarum is a rare clinical isolate of primary cutaneous infections. This report describes a case of lymphocutaneous nocardiosis caused by N. otitidiscaviarum. Analysis of 16S ribosomal RNA gene of the isolate and the type strain of N. otitidiscaviarum DSM 43242 showed 100% similarity. The partial gene sequence of 1439 bp was submitted to GenBank. (EU031786). The isolate was susceptible only to amikacin, minocycline, linezolid and resistant to remaining other routine anti-nocardial drugs. The patient was free of nocardiosis after 12 weeks of treatment with amikacin and linezolid. We reviewed four other cases of lymphocutaneous nocardiosis caused by N. otitidiscaviarum.

Primary lymphocutaneous nocardiosis due to Nocardia brasiliensis which was successfully treated with only oral potassium iodide

The Journal of DermatologyVolume 38, Issue 8 p. 826-828 LETTERS TO THE EDITOR Primary lymphocutaneous nocardiosis due to Nocardia brasiliensis which was successfully treated with only oral potassium iodide Naohiko AOZASA, Naohiko AOZASA Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this authorMasahiro KISO, Masahiro KISO Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this authorTakehiko KANEKO, Takehiko KANEKO Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this author Naohiko AOZASA, Naohiko AOZASA Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this authorMasahiro KISO, Masahiro KISO Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this authorTakehiko KANEKO, Takehiko KANEKO Department of Dermatology, The Fraternity Memorial Hospital, Tokyo, JapanSearch for more papers by this author First published: 23 November 2010 https://doi.org/10.1111/j.1346-8138.2010.01074.xCitations: 3 Takehiko Kaneko, M.D., Ph.D., Department of Dermatology, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo 130-8587, Japan. Email: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume38, Issue8August 2011Pages 826-828 RelatedInformation

A Case of Lymphocutaneous Nocardiosis with a Myeloproliferative Disorder Which First Seemed to be Sporotrichosis

A Case of Lymphocutaneous Nocardiosis with a Myeloproliferative Disorder Which First Seemed to be Sporotrichosis

Lymphocutaneous nocardiosis and cutaneous pheohyphomycosis in a liver transplant recipient

Infections are the leading cause of morbidity and mortality in transplanted patients. The increasing number of immunocompromised patients has not only augmented infections by specific pathogens, but also by opportunistic microbial agents. A mixed cutaneous infection caused by Nocardia brasiliensis and Exophiala jeanselmei is reported in a liver transplant patient. The cutaneous lesions were painful nodules which drained purulent material. They were located on the right lower limb, with lymphadenopathies in the groin. The patient was treated with itraconazole (600 mg/day) plus trimethoprim (1600 mg/day)-sulfamethoxazole (320 mg/day) for 8 weeks, with complete remission of the lesions.

Lymphocutaneous Nocardiosis in a Lymphopenic Breast Cancer Patient under Treatment with Docetaxel

The Breast JournalVolume 11, Issue 6 p. 469-469 Lymphocutaneous Nocardiosis in a Lymphopenic Breast Cancer Patient under Treatment with Docetaxel Stavros Apostolakis MD, Stavros Apostolakis MD Medical Oncology Unit andSearch for more papers by this authorIoannis Chalkiadakis MD, Ioannis Chalkiadakis MD Medical Oncology Unit andSearch for more papers by this authorMaria Ventouri MD, Maria Ventouri MD Department of Clinical Microbiology, “Venizeleio-Pananeio” G. H., Herakleio, Crete; andSearch for more papers by this authorSofia Maraki MD, Sofia Maraki MD Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, University Hospital, Herakleio, CreteSearch for more papers by this authorSophocles Tsoussis MD, Sophocles Tsoussis MD Medical Oncology Unit andSearch for more papers by this author Stavros Apostolakis MD, Stavros Apostolakis MD Medical Oncology Unit andSearch for more papers by this authorIoannis Chalkiadakis MD, Ioannis Chalkiadakis MD Medical Oncology Unit andSearch for more papers by this authorMaria Ventouri MD, Maria Ventouri MD Department of Clinical Microbiology, “Venizeleio-Pananeio” G. H., Herakleio, Crete; andSearch for more papers by this authorSofia Maraki MD, Sofia Maraki MD Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, University Hospital, Herakleio, CreteSearch for more papers by this authorSophocles Tsoussis MD, Sophocles Tsoussis MD Medical Oncology Unit andSearch for more papers by this author First published: 10 November 2005 https://doi.org/10.1111/j.1075-122X.2005.00155.xCitations: 2 Address correspondence and reprint requests to: Sophocles Tsoussis, MD, Medical Oncology Unit, “Venizeleio-Pananeio” G. H., Knossou Ave., Herakleio, Crete 71,409, or e-mail: tsoussis@hygeianet.gr. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume11, Issue6November 2005Pages 469-469 RelatedInformation

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

We describe a case of concurrent double infection with phaeohyphomycosis and lymphocutaneous nocardiosis in an immunocompromised host. The episode occurred almost simultaneously with an incident of insect bites. Exophiala spinifera was isolated from lesions on the left arm and Nocardia asteroides was isolated from lesions on the right hand. Clinical resolution occurred within 5 months after initiation of antimicrobial treatment with oral itraconazole and minocycline. We believe that this case represents a novel episode of previously unreported concurrent infections with phaeohyphomycosis and lymphocutaneous nocardiosis in human beings.

Primary lymphocutaneous nocardiosis in an immunocompetent patient

BackgroundNocardia brasiliensis is a rare human pathogen usually associated with localized cutaneous infections.Case PresentationWe report a case of primary lymphocutaneous Nocardia brasiliensis infection developed after a bone fracture of the left hand of an otherwise healthy 32-year-old man. Treatment with trimethoprim-sulfamethoxazole given for a total of three months combined with surgical debridement resulted in complete resolution of the infection.ConclusionNocardiosis should be part of the differential diagnosis in patients with sporotrichoid infection, particularly those with a history of outdoor injury. Culture of the affected tissue and antimicrobial susceptibility testing of the isolate should be performed for diagnosis and treatment.

顔面・頚部の皮膚リンパ型ノカルジア症例

Primary lymphocutaneous nocardiosis in the face and neck region appears to be rare in Japan. A 43-year-old woman presented with an erythematous papule at our clinic. Oral medication with FRPM was administered but, the pustule increased in size and the lesions spread to regional lymph nodes. Clinical examination revealed a 2×3cm induration with skin redness and a few small whitish pustules on the right side of the face and neck region. A general physical examination revealed no other abnormal findings. The laboratory investigation showed a white blood cell count of 9, 700 cells/μl, CRP 7.6mg/dl. After Nocardia was isolated from the aspirated pus, the patient was treated with sulfamethoxazole/trimethprim, minocycline. A CT scan revealed abscess foration in the right neck. An incision and drainage for the abscess was performed. The patient has remained asymptomatic for 15 months after discharge without medication.

Primary Lymphocutaneous Nocardiosis Due to Nocardia otitidiscaviarum: The First Case Report from Japan

We report a case of lymphocutaneous syndrome caused by Nocardia otitidiscaviarum (formerly known as N. caviae) in a 78-year-old woman who underwent long-term therapy with prednisolone for bronchial asthma. Histological examination showed granulomatous reaction with multiple polymorphonuclear leukocytes and revealed a Gram positive filament in the dermis. Gram-positive, slightly acid-fast branched filaments were also found in the smear of the purulent material. The cell wall constituents of the isolate were meso-diaminopimelic acid, arabinose, and galactose; the mycolic acid pattern of the isolate was Nocardia type. The organism decomposed xanthine and hypoxanthine, but not tyrosine or casein, which distinguished it from N. asteroides and N. brasiliensis. The skin lesions responded to minocycline and later to a combination of doxycycline and ofloxacin. This primary lymphocutaneous nocardiosis due to N. otitidiseaviarum is the first in Japan.

Lymphocutaneous nocardiosis caused by Nocardia caviae: The first case report from Asia

Lymphocutaneous nocardiosis caused by Nocardia caviae: The first case report from Asia

Primary lymphocutaneous nocardiosis caused by an unusual species of Nocardia: Nocardia transvalensis

We present the first case of lymphocutaneous nocardiosis caused by Nocardia transvalensis and the seventh report of infection caused by this microorganism. The patient was allergic to sulfonamides but responded to amikacin and cefotaxime and later to erythromycin. The treatment and criteria for differentiation of cutaneous Nocardia species infection are discussed.

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

\s=b\A 22-year-old man developed erythematous nodules and an ulcer mimicking sporotrichosis on his right hand and forearm, which was subsequently diagnosed as lymphocutaneous nocardiosis caused by Nocardia asteroides. To our knowledge, 21 cases of lymphocutaneous nocardiosis have been reported, with the majority of those cases, except for a few that remain uncertain, being due to Nocardia brasiliensis. The case reported herein, the first known definitive case caused by N asteroides (to our knowledge), showed a more chronic

Lymphocutaneous Nocardiosis Caused by Nocardia asteroides

A 22-year-old man developed erythematous nodules and an ulcer mimicking sporotrichosis on his right hand and forearm, which was subsequently diagnosed as lymphocutaneous nocardiosis caused by Nocardia asteroides. To our knowledge, 21 cases of lymphocutaneous nocardiosis have been reported, with the majority of those cases, except for a few that remain uncertain, being due to Nocardia brasiliensis. The case reported herein, the first known definitive case caused by N asteroides (to our knowledge), showed a more chronic course and less inflammatory manifestation compared with that caused by N brasiliensis. This is probably because N brasiliensis has a stronger virulence than N asteroides.