Lai Kimberly W, Brodell Lindsey A, Lambert Emily, Menegus Marilyn, Scott Glynis A, Tu John H
Department of Dermatology, University of Rochester School of Medicine and Dentistry, New York, USA.
Cutis. 2012 Feb;89(2):75-7.
Cutaneous nocardiosis is a rare infection that may manifest as a superficial skin lesion, lymphocutaneous infection, mycetoma, or diffuse cutaneous infection from a disseminated systemic infection. We report a case of a 65-year-old immunocompromised man with persistent primary cutaneous Nocardia brasiliensis infection following a motor vehicle collision. A high degree of suspicion is needed to diagnose Nocardia infection because of its resemblance to other bacterial infections. Nocardiosis should be included in the differential diagnosis of chronic cutaneous infections, especially when the response to antibiotics is inadequate or when the patient is immunocompromised. Because Nocardia may take several weeks to grow in standard bacterial culture media, laboratories should be notified of the suspicion so that culture plates are held for longer time periods. Long-term therapy, usually with sulfonamides, often is necessary.
皮肤诺卡菌病是一种罕见的感染，可表现为浅表皮肤病变、淋巴管皮肤感染、足菌肿，或由播散性全身感染引起的弥漫性皮肤感染。我们报告一例65岁免疫功能低下男性在机动车碰撞后发生持续性原发性巴西诺卡菌皮肤感染的病例。由于诺卡菌感染与其他细菌感染相似，因此诊断时需要高度怀疑。诺卡菌病应列入慢性皮肤感染的鉴别诊断，特别是当对抗生素治疗反应不佳或患者免疫功能低下时。由于诺卡菌在标准细菌培养基中可能需要数周才能生长，因此应告知实验室存在怀疑，以便延长培养平板的保存时间。通常需要长期使用磺胺类药物进行治疗。
