Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA.
Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA.
Medicina (Kaunas). 2022 Mar 28;58(4):488. doi: 10.3390/medicina58040488.
spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestations of cutaneous disease are varied and frequently misdiagnosed. We present a case of an immunocompetent 66-year-old man who sustained a left finger injury while gardening. He was misdiagnosed on several occasions and treated with inappropriate antibiotics against spp. and spp. When infection spread cutaneously, sporotrichoid (lymphocutaneous) nocardiosis was suspected and the patient was started on appropriate therapy with Bactrim which resulted in a cure. We also summarize the literature on lymphocutaneous infection by . By reporting this case, we want to raise awareness among clinicians about unusual causes of cellulitis, the differential diagnosis of lymphocutaneous infection and the importance of obtaining a detailed exposure history to assist in the prompt diagnosis of nocardiosis.
spp. 是一种革兰氏阳性、部分抗酸、需氧细菌,通常与免疫功能低下者的感染有关。最常见的感染部位是皮肤、肺部和大脑,但疾病可能会扩散并影响每个器官。皮肤疾病的临床表现多种多样,经常被误诊。我们报告了一例免疫功能正常的 66 岁男性,他在园艺时左手手指受伤。他曾多次被误诊,并接受了针对 spp. 和 spp. 的不适当抗生素治疗。当感染扩散至皮肤时,怀疑发生了孢子丝菌病(淋巴管性)诺卡菌病,患者开始接受磺胺甲噁唑治疗,结果治愈。我们还总结了有关 的淋巴管性感染的文献。通过报告这个病例,我们希望提高临床医生对蜂窝织炎的不常见病因、淋巴管性感染的鉴别诊断以及获取详细暴露史以协助及时诊断诺卡菌病的认识。