[Nocardiosis in immunocompromised host presenting as cellulitis].
Nocardia is a rare pathogen of mainly immunocomprised patients. Only two cases of nocardiosis have previously been identified in Iceland.



A 92-year-old male on glucocorticoid therapy with metastatic bladder cancer presented with two weeks history of progressive swelling and erythema of the hand and deteriorating cognitive functioning. A brain lesion and pulmonary nodules were identified and Nocardia farcinia was cultured from a hand abscess. The patient was initially treated with trimethoprim/sulfamethoxazole but because of rapid deterioration and old age an end-of-life decision was made.



This case of nocardiosis illustrates the importance of uncommon opportunistic infections in immunocompromised Icelandic patients.
Hilmar
H
Asgeirsson
Bryndis
B
Sigurdardottir
D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D004487:Edema / Q000382:microbiology; D004890:Erythema / Q000382:microbiology; D005938:Glucocorticoids / Q000009:adverse effects*; D006225:Hand; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D009894:Opportunistic Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000556:secondary
D000890:Anti-Infective Agents; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination