title: Disseminated nocardia cyriacigeorgica presenting as right lung abscess and skin nodule.
abstract: Nocardia species are ubiquitous in the environment and can be found worldwide. Direct inhalation remains the most commonly attributed route of infection with Nocardia asteroides complex, causing 50% of invasive infections. Improved molecular methods have identified a significant proportion of N. asteroides complex isolates to be Nocardia cyriacigeorgica. We report a case of a 58-year-old male working as a contractor in Bagram Air Force Base, Afghanistan, with disseminated N. cyriacigeorgica involving the lung, brain, and dermis. Diagnosis was facilitated by early identification of branched, filamentous bacteria using Fite and gram staining along secA DNA sequencing of clinical isolates. Our patient is the first confirmed case of N. cyriacigeorgica infection in Afghanistan.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5000, USA.
authors.forename: Temujin T
authors.initials: TT
authors.lastname: Chavez
authors.forename: Susan L
authors.initials: SL
authors.lastname: Fraser
authors.forename: David
authors.initials: D
authors.lastname: Kassop
authors.forename: Lynden P
authors.initials: LP
authors.lastname: Bowden
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Skidmore
mesh_terms: D055826:Afghan Campaign 2001-; D001706:Biopsy; D003937:Diagnosis, Differential; D005845:Georgia; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000382:microbiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000382:microbiology*; D014057:Tomography, X-Ray Computed