Schiff T A, McNeil M M, Brown J M
Department of Dermatology, New York University Medical Center, New York 10016.
Clin Infect Dis. 1993 Jun;16(6):756-60. doi: 10.1093/clind/16.6.756.
Nocardia farcinica, the etiologic agent of bovine farcy, is microbiologically related to but distinct from Nocardia asteroides. N. farcinica is noted for its propensity to cause serious systemic infection in both normal and immunocompromised hosts and its marked degree of resistance to multiple antimicrobial agents. We present a case in which a nonimmunocompromised patient who sustained a contaminated facial laceration developed an abscess due to N. farcinica with underlying osteomyelitis. The severity of the infection necessitated surgical debridement followed by administration of intravenous amikacin therapy. The isolate was susceptible to amikacin and trimethoprim-sulfamethoxazole but resistant to erythromycin in vitro. Therapy with trimethoprim-sulfamethoxazole was started but was discontinued because of the patient's intolerance to the drug. Intramuscular amikacin was substituted, resulting in complete resolution of the infection. The history, epidemiology, and microbiological characteristics of this interesting and unusual microorganism are reviewed.
鼻疽诺卡菌是牛鼻疽的病原体，在微生物学上与星形诺卡菌相关但不同。鼻疽诺卡菌以其在正常宿主和免疫功能低下宿主中均易引发严重全身感染以及对多种抗菌药物具有显著耐药性而闻名。我们报告一例病例，一名非免疫功能低下的患者面部撕裂伤受到污染后，因鼻疽诺卡菌感染形成脓肿并伴有潜在骨髓炎。感染的严重程度需要进行手术清创，随后给予静脉注射阿米卡星治疗。该分离株在体外对阿米卡星和甲氧苄啶 - 磺胺甲恶唑敏感，但对红霉素耐药。开始使用甲氧苄啶 - 磺胺甲恶唑治疗，但因患者对该药物不耐受而停药。改用肌肉注射阿米卡星，感染得以完全消退。本文对这种有趣且不寻常的微生物的病史、流行病学和微生物学特征进行了综述。
