Skin Infections Caused by Nocardia Species A Case Report and Review of the Literature of Primary Cutaneous Nocardiosis Reported in the United States

Nocardiosis is an uncommon infection caused by Nocardia species, a group of aerobic actinomycetes. Disease in humans is rare and often affects patients with underlying immune compromise. Acquisition of this organism is usually via the respiratory tract, but direct inoculation into the skin is possible, usually in the setting of trauma. We report an encounter of a previously healthy man, with cellulitis and abscess formation of the upper arm. The organism isolated from the wound culture was a partially acid-fast, Gram-positive rod, identified as Nocardia species. Our patient recovered after 6 months of treatment with trimethoprimsulfamethoxazole. Along with our case, we reviewed the profile of patients with primary cutaneous nocardiosis reported in the United States between 1985 and 2010. We emphasize that Nocardia infection should be considered in the differential diagnosis of skin lesions especially if a person has a history of trauma or failed prior antibiotic therapy.