Nocardiosis. Case report and review of the diagnosis and treatment.
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.
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy; D009616:Nocardia asteroides; D013411:Sulfadiazine / Q000627:therapeutic use
D013411:Sulfadiazine