Anzalone C Lane, Cohen Philip R, Tarrand Jeffrey J, Diwan Abdul H, Prieto Victor G
Tumori. 2013 Jul-Aug;99(4):e156-8. doi: 10.1177/030089161309900424.
Nocardia are ubiquitous, aerobic, gram-positive actinomycetes. Nocardiosis typically occurs in immunocompromised patients, although immunocompetent individuals can also be affected.
The purpose of this case study is to review the clinical characteristics and treatments of a unique form of cutaneous nocardiosis.
We retrospectively reviewed the medical literature using PubMed, searching the terms cutaneous, host, immunocompromised, Nocardia, primary, yamanashiensis. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented.
Cutaneous nocardiosis typically presents as pustular nodules and the lesions may progress to become abscesses, cellulitis, granulomas or keloid-like tumors. N. brasiliensis is the predominant species involved in primary cutaneous nocardiosis; other common Nocardia species involved in human disease are N. farcinica, N. abscessus, N. cyriacigeorgica, and N. nova. Only two individuals (including the patient presented here) with primary cutaneous infection by N. yamanashiensis have been described in the literature; a third clinical isolate was recovered from a lung biopsy.
Nocardia yamanashiensis is a rare clinical form of primary cutaneous nocardiosis. 16S ribosomal gene sequencing, as well as Gram stain and modified Fite acid-fast stain, play a vital role in identifying this clinical variant.
诺卡菌是普遍存在的需氧革兰氏阳性放线菌。诺卡菌病通常发生在免疫功能低下的患者中，不过免疫功能正常的个体也可能受到影响。
本病例研究的目的是回顾一种独特形式的皮肤诺卡菌病的临床特征及治疗方法。
我们使用PubMed对医学文献进行了回顾性检索，搜索了“皮肤的”“宿主”“免疫功能低下的”“诺卡菌”“原发性”“山梨诺卡菌”等关键词。对患者报告及此前关于该主题的综述进行了严格评估，并呈现了显著特征。
皮肤诺卡菌病通常表现为脓疱结节，病变可能进展为脓肿、蜂窝织炎、肉芽肿或瘢痕疙瘩样肿瘤。巴西诺卡菌是原发性皮肤诺卡菌病的主要致病菌种；其他与人类疾病相关的常见诺卡菌种有嗜皮诺卡菌、脓肿诺卡菌、乔治亚诺卡菌和新星诺卡菌。文献中仅描述了两名（包括此处报告的患者）原发性皮肤感染山梨诺卡菌的个体；从一份肺活检标本中分离出了第三株临床菌株。
山梨诺卡菌是原发性皮肤诺卡菌病的一种罕见临床类型。16S核糖体基因测序以及革兰氏染色和改良抗酸染色在识别这种临床变异型中起着至关重要的作用。
