Case Report A protracted primary cutaneous nocardiosis due to Nocardia otitidiscaviarum

Nocardia otitidiscaviarum was seldom reported to cause primary cutaneous nocardiosis, which is difficult to diagnosis due to its nonspecific clinical features. Misdiagnosis of the disease could result in inappropriate treatment and chronic protracted lesions. In this report, we described a previously misdiagnosed case of primary cutaneous nocardiosis caused by N. otitidiscaviarum in a 30-year-old, immune-sufficient male patient. The culture of the lesion pus revealed gram-positive and partially acid-fast positive bacilli. The analysis of 16S ribosomal RNA gene of the isolates showed 100% similarity with the type strain of N. otitidiscaviarum ATCC 14629. The patient was cured after 3 months of treatment with doxycycline and trimethoprim-sulfamethoxazole. We also presented a brief review of the literatures on N. otitidiscaviarum and summarized the features of cutaneous infection of this bacteria.