Mycetoma caused by Nocardia yamanashiensis, Papua New Guinea.
We report the first documented case of a mycetoma caused by Nocardia yamanashiensis after the initial description of this species. The 16S-rRNA gene sequence analysis was used to identify the novel species, which showed a similarity of 99.9% to the gene sequence of the type strain. The case showed both clinical non-response and reduced susceptibility in vitro to amoxicillin plus clavulanate, and it was treated successfully with trimethoprim-sulfamethoxazole and doxycycline. Given antibiotic resistance concerns, we suggest that antimicrobial susceptibility testing should be done for the majority of Nocardia species without well-established resistance patterns.
Lihir Medical Centre - International SOS, Lihir Island, Papua New Guinea. oriolmitja@hotmail.com
Oriol
O
Mitjà
Russell
R
Hays
Christian
C
Van Straten
Jenny
J
Robson
Murray
M
Koka
Quique
Q
Bassat
D000284:Administration, Oral; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019818:Clavulanic Acid / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008271:Mycetoma / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D009615:Nocardia / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D010219:Papua New Guinea; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination