title: Multiple cutaneous abscesses revealing disseminated nocardiosis in a patient with chronic rheumatoid arthritis.
abstract: Nocardiosis is a challenging infection that is difficult to diagnose and treat. Delayed recognition and prolonged illness are major concerns. We report the case of a 65-year-old man who underwent treatment with corticosteroids for rheumatoid arthritis and then presented with multiple abscesses on the right leg. A complete assessment performed by the dermatologist led to the diagnosis of disseminated nocardiosis with involvement of the lungs and central nervous system. The patient's history revealed development of pulmonary disease approximately 1 year prior to the appearance of the skin lesions, which was not recognized by several specialists. Long-term antibiotic therapy was effective in treating the skin and central nervous system lesions, while the chest radiologic profile improved more slowly.
authors.affiliation: Clinica Dermatologica, Via Ospedale 54, 09124 Cagliari, Italy. laura.atzori@libero.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Atzori
authors.forename: Monica
authors.initials: M
authors.lastname: Pau
authors.forename: Nicola
authors.initials: N
authors.lastname: Aste
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002494:Central Nervous System Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents