title: Nocardia nova mycetoma over forehead in a lepromatous leprosy patient.
abstract: We present a case of a 31-year-old male, a known patient with lepromatous leprosy with a type 2 lepra reaction, who presented with a slowly growing asymptomatic swelling with multiple discharging sinuses over the forehead that developed over 6 months. Smears of the serosanguinous discharge on Gram staining showed Gram-positive branching filamentous bacilli, which on culture on blood agar showed chalky-white colonies. Histology of the lesion showed suppurative granulomas with polymorphs surrounding characteristic grains. The isolate was identified as Nocardia nova by gene sequencing and the patient was started on combined antibiotic therapy that resulted in complete resolution of the infection in six months. To the best of our knowledge, this is the first report of mycetoma related to Nocardia nova in association with leprosy.
authors.affiliation: Department of Dermatology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: M
authors.initials: M
authors.lastname: Dhingra
authors.forename: N
authors.initials: N
authors.lastname: Kaistha
authors.forename: N
authors.initials: N
authors.lastname: Bansal
authors.forename: L S
authors.initials: LS
authors.lastname: Solanki
authors.forename: J
authors.initials: J
authors.lastname: Chander
authors.forename: G P
authors.initials: GP
authors.lastname: Thami
authors.forename: W W
authors.initials: WW
authors.lastname: van de Sande
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005546:Forehead; D006099:Granuloma / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000150:complications*; D008297:Male; D008271:Mycetoma / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D009617:Nocardia Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D007917:Leprostatic Agents