title: Primary lymphocutaneous nocardiosis due to Nocardia otitidiscaviarum: the first case report from Japan.
abstract: We report a case of lymphocutaneous syndrome caused by Nocardia otitidiscaviarum (formerly known as N. caviae) in a 78-year-old woman who underwent long-term therapy with prednisolone for bronchial asthma. Histological examination showed granulomatous reaction with multiple polymorphonuclear leukocytes and revealed a Gram positive filament in the dermis. Gram-positive, slightly acid-fast branched filaments were also found in the smear of the purulent material. The cell wall constituents of the isolate were meso-diaminopimelic acid, arabinose, and galactose; the mycolic acid pattern of the isolate was Nocardia type. The organism decomposed xanthine and hypoxanthine, but not tyrosine or casein, which distinguished it from N. asteroides and N. brasiliensis. The skin lesions responded to minocycline and later to a combination of doxycycline and ofloxacin. This primary lymphocutaneous nocardiosis due to N. otitidiseaviarum is the first in Japan.
authors.affiliation: Department of Dermatology, Chiba University, School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Toyama
authors.forename: K
authors.initials: K
authors.lastname: Utsugi
authors.forename: K
authors.initials: K
authors.lastname: Yazawa
authors.forename: Y
authors.initials: Y
authors.lastname: Mikami
authors.forename: M
authors.initials: M
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Shinkai
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007564:Japan; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents