We report a case of a 42-year-old woman who suffered from recurrent nodular skin lesions on her left foot. Sporotrichoid fungal infection was suspected and two linear nodular skin lesions that had occurred after trauma in a public pool were treated with itraconazole for 4 months. These nodular skin lesions were completely flattened. However, four months after complete flattening, a new lesion developed in the scar of a previous nodule. N. asteroides, which is extremely rare for sporotrichoid cutaneous nocardiosis, was cultured from the relapsed lesion. We treated this case with trimethoprim-sulfamethoxazole for 6 months under an emperical basis and this resulted in complete healing, and sensitivity of N. asteroide to trimethoprim-sulfamethoxazole was confirmed later. There has been no recurrence for 3 years. To our knowledge, our case is the first report in the english literature of primary sporotrichoid cutaneous nocardiosis caused by N. asteroides in terms of anatomic location below the knee and host immunocompetency.
Adult ; Cicatrix ; Female ; Foot ; Humans ; Itraconazole ; Knee ; Nocardia asteroides* ; Nocardia Infections* ; Nocardia* ; Recurrence ; Skin ; Trimethoprim, Sulfamethoxazole Drug Combination

Nocardia is an aerobic gram-positive, weak acid-fast, branching, filamentous bacteria causing various clinical infections such as pulmonary nocardiosis, systemic nocardiosis, extrapulmonary nocardiosis, cutaneous nocardiosis and nocardial mycetoma. They are most commonly caused by N. asteroides complex. Humans become infected by inhaling contaminated air-borne dust particles or by traumatic implantation of the bacterium into the subcutaneous tissues. We isolated Nocardia asteroides complex from the hemo-vac of trauma patient and CSFs of two hydrocephalus patients. Nocardia asteroides complex has been isolated less commonly in Korea than in other countries. We think that it is important to extend an incubation time of culture plate when we find the gram positive, branched, beaded filaments and coccoid cells.
Bacteria ; Cerebrospinal Fluid* ; Dust ; Humans ; Hydrocephalus ; Inhalation ; Korea ; Mycetoma ; Nocardia asteroides* ; Nocardia Infections ; Nocardia* ; Subcutaneous Tissue ; Wounds and Injuries*

Nocardia is a significant opportunistic pathogen in patients with compromised immunity. The authors isolated N. asteroides from an abscess of the axilla and from respiratory specimens of a renal allograft patient with pneumonia. Direct smear of the sputum and bronchial washing specimens showed many branching, filamentous forms which were gram-positive and acid fast. Culture yielded slow growing small white colonies which became orange on further incubation. Aerial hyphae were produced. Identification of the species was based on typical cultural and biochemical tests. The isolate was susceptible to amikacin, minocycline and rifamipicin. The patient became afebrile after 8 weeks of treatment with cotrimoxazole and brief treatment with other antimicrobial agents.
Adult ; Human ; Kidney Transplantation* ; Lung Diseases/etiology* ; Male ; Nocardia Infections/etiology* ; Nocardia asteroides/isolation & purification

No abstract available.
Nocardia Infections* ; Nocardia*

Opportunistic infections are common after a renal transplant as a result of immunosuppression. Nocardiosis is a rare but important cause of morbidity and mortality among renal transplant recipi-ents. Nocardiosis is a localized or disseminated infection, which is usually introduced through the respiratory tract resulting in pneumonia, and may develop a disseminated infection, in particular a subcutaneous abscess and/or central nervous system infection. Because effective therapy for these nocardiosis is available, an accurate and timely diagnosis is crucial. However, nocardiosis is an infrequent disease and many physicians are unfamiliar to it. In addition, in the laboratory, cul-tures may be discarded too early, which often delays an early diagnosis and treatment. The authors isolated Nocardia asteroides from an abscess of the skin in a rejected renal allograft patient suffering pneumonia. The patient was successfully treated with trimethoprim/sulfamethoxa-zole.
Abscess* ; Allografts ; Central Nervous System Infections ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; Kidney* ; Mortality ; Nocardia asteroides* ; Nocardia Infections ; Nocardia* ; Opportunistic Infections ; Pneumonia ; Respiratory System ; Skin

Nocardia is a kind of aerobic Actinomycetes, gram positive organism that was acid-fast when stained with the modified Ziehl-Neelsen method. Nocardia is a soil saprophyte widely distributed throughout the world which usually introduced through the respiratory tract and may develop a disseminated infection, especially subcutaneous abscess and or central nervous system infection. Nocardiosis is an important opportunistic infection in immunosuppressed patients, lymphoma, sarcoidosis, and organ transplant patient. Sulfonamide therapy is known as a treatment of choice in nocardiosis. We report the two cases of nocardiosis in renal transplant recipient. Nocardia asteroides was isolated in our two cases. We treated sucessfully with Trimethoprim/Sulfamethoxazole(Bactrim).
Abscess ; Actinobacteria ; Central Nervous System Infections ; Humans ; Lymphoma ; Nocardia ; Nocardia asteroides ; Nocardia Infections ; Opportunistic Infections ; Respiratory System ; Sarcoidosis ; Soil ; Transplantation* ; Transplants

No abstract available.
Abscess* ; Nocardia*

No abstract available.
Nocardia* ; Pneumonia*

No abstract available.
Nocardia Infections*

A 52 year-old, contact lens-wearing man presented with progressive right eye pain and redness for one month. He had been evaluated and treated for necrotizing scleritis by multiple eye care specialists prior to presentation. He underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis, including a culture. The culture revealed heavy growth of Nocardia asteroides complexes. The patient was treated with topical amikacin and oral Bactrim. Following several weeks of antibiotic treatment, the patient's infection resolved completely, and his visual acuity returned to baseline status. Nocardia is a rare but potentially devastating cause of necrotizing scleritis that may affect contact lens wearers without an associated keratitis. Prompt recognition and early treatment with appropriate antimicrobial agents are critical to achieve a favorable outcome.
Anti-Bacterial Agents/therapeutic use ; Contact Lenses/*adverse effects/*microbiology ; Humans ; Male ; Middle Aged ; Nocardia Infections/*diagnosis/drug therapy ; Nocardia asteroides/*isolation & purification ; Scleritis/drug therapy/*microbiology