Diagnosis of Cutaneous Nocardiosis with Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS).
10.17966/KJMM.2016.21.2.39
- Author:
Kyou Chae LEE
1
;
Min Ji KIM
;
Dong Hyuk EUN
;
Hae Sook LEE
;
Yong Hyun JANG
;
Seok Jong LEE
;
Do Won KIM
;
Weon Ju LEE
Author Information
1. Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea. weonju@knu.ac.kr
- Publication Type:Case Report
- Keywords:
MALDI-TOF MS;
Nocardiosis
- MeSH:
Aged;
Biopsy;
Communicable Diseases;
Cost-Benefit Analysis;
Diagnosis*;
Female;
Forearm;
Genes, rRNA;
Humans;
Inflammation;
Korea;
Mass Spectrometry*;
Methods;
Nocardia;
Nocardia Infections*;
Sequence Analysis;
Skin;
Suppuration;
Ulcer;
Wrist
- From:Korean Journal of Medical Mycology
2016;21(2):39-46
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Nocardiosis is a rare but potentially life-threatening infectious disease caused by several species of the genus Nocardia (N.), which are aerobic, filamentous, gram-positive bacilli. A definitive diagnosis depends on the isolation and identification of Nocardia species. But identification from clinical specimens may involve performing invasive techniques on the patient and lengthy process (take up to 1 or 3 weeks) owing to slow growth, and require a professional microbiologist. Currently the genus Nocardia is best identified using 16S rRNA and 18S rRNA gene sequence analysis. Recently matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has launched a new era in the routine microbiology laboratory. This method has proved its efficacy for the identification and diagnosis of microorganism. MALDI-TOF MS has potential for use as a rapid (within 1 hour) and dependable method for the identification of Nocardia species with reproducibility and cost effectiveness. We report a 76-year-old woman who suffered from ulcer with papules on her right wrist and forearm. A biopsy of the skin showed granulomatous inflammation with central suppuration. A bacterial isolate from the skin was identified to be N. brasiliensis on comparative 16S rRNA gene sequencing and MALDI-TOF MS. To the best of our knowledge, this is the first case of nocardiosis in Korea caused by N. brasiliensis identified on MALDI-TOF MS.
