Nocardia farcinica complicating Cogan's syndrome

Nocardiosis is an uncommon bacterial gram-positive infection caused by aerobic actinomycetes in the genus Nocardia. Nocardiosis is typically regarded as an opportunistic infection with approximately two-thirds of infected patients being immunocompromised. In this case report we describe a 45-year-old female who presented with a right thigh abscess. She had been taking high-dose prednisolone and ciclosporin for Cogan's syndrome. She presented with erythema and severe pain over her right thigh. Ultrasound showed a collection and Nocardia farcinica was isolated. This case report stresses the importance of considering atypical infections in immunocompromised patients, even with minor symptoms, to avoid delay in diagnosis and treatment.