title: Nocardia yamanashiensis in an immunocompromised patient presenting as an indurated nodule on the dorsal hand.
abstract: BACKGROUND
  Nocardia are ubiquitous, aerobic, gram-positive actinomycetes. Nocardiosis typically occurs in immunocompromised patients, although immunocompetent individuals can also be affected.
  
  
  OBJECTIVE
  The purpose of this case study is to review the clinical characteristics and treatments of a unique form of cutaneous nocardiosis.
  
  
  METHODS
  We retrospectively reviewed the medical literature using PubMed, searching the terms cutaneous, host, immunocompromised, Nocardia, primary, yamanashiensis. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented.
  
  
  RESULTS
  Cutaneous nocardiosis typically presents as pustular nodules and the lesions may progress to become abscesses, cellulitis, granulomas or keloid-like tumors. N. brasiliensis is the predominant species involved in primary cutaneous nocardiosis; other common Nocardia species involved in human disease are N. farcinica, N. abscessus, N. cyriacigeorgica, and N. nova. Only two individuals (including the patient presented here) with primary cutaneous infection by N. yamanashiensis have been described in the literature; a third clinical isolate was recovered from a lung biopsy.
  
  
  CONCLUSIONS
  Nocardia yamanashiensis is a rare clinical form of primary cutaneous nocardiosis. 16S ribosomal gene sequencing, as well as Gram stain and modified Fite acid-fast stain, play a vital role in identifying this clinical variant.
authors: C Lane
authors: CL
authors: Anzalone
authors: Philip R
authors: PR
authors: Cohen
authors: Jeffrey J
authors: JJ
authors: Tarrand
authors: Abdul H
authors: AH
authors: Diwan
authors: Victor G
authors: VG
authors: Prieto
mesh_terms: D000038:Abscess / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000628:therapy; D006225:Hand; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D009615:Nocardia / Q000145:classification / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents