De Villiers D M
S Afr Med J. 1978 Jul 8;54(2):71-3.
Purulent draining skin sinuses are a striking clinical finding when Nocardia organisms infect skin or deeper tissues and the lesion is often mistakenly ascribed to actinomycotic infection. This distinction is important because in contrast to actinomycosis, nocardiosis does not respond to treatment with penicillin or most antibiotics, and a fulminating systemic infection may occur. Smears made from purulent discharges do not always show the organism and microbiological culture may likewise prove fruitless. This article reports a patient suffering from nocardiosis and the pitfalls in diagnosis are illustrated. Successful culture of the organism was obtained by inoculating media with fresh biopsy material and a plea is made for routine use of this method. The need to use sulphadiazine in high doses initially, followed by maintenance treatment for considerable time, is emphasized.
当诺卡菌属微生物感染皮肤或更深层组织时，脓性引流性皮肤窦道是一个显著的临床发现，且该病变常被误诊为放线菌感染。这种区分很重要，因为与放线菌病不同，诺卡菌病对青霉素或大多数抗生素治疗无反应，可能会发生暴发性全身感染。脓性分泌物涂片并不总能显示出该微生物，微生物培养同样可能无果。本文报告了一名患有诺卡菌病的患者，并阐述了诊断中的陷阱。通过用新鲜活检材料接种培养基成功培养出了该微生物，并呼吁常规使用此方法。强调了最初需大剂量使用磺胺嘧啶，随后进行相当长时间维持治疗的必要性。
