Nocardiosis is an uncommon infection caused by Nocardia species, a group of aerobic actinomycetes. Disease in humans is rare and often affects patients with underlying immune compromise. Acquisition of this organism is usually via the respiratory tract, but direct inoculation into the skin is possible, usually in the setting of trauma. We report an encounter of a previously healthy man, with cellulitis and abscess formation of the upper arm. The organism isolated from the wound culture was a partially acid-fast, Gram-positive rod, identified as Nocardia species. Our patient recovered after 6 months of treatment with trimethoprim-sulfamethoxazole. Along with our case, we reviewed the profile of patients with primary cutaneous nocardiosis reported in the United States between 1985 and 2010. We emphasize that Nocardia infection should be considered in the differential diagnosis of skin lesions especially if a person has a history of trauma or failed prior antibiotic therapy.
From the *Department of Medicine and †Infectious Disease Section, Department of Medicine, Danbury Hospital, Danbury, CT; and ‡University of Vermont College of Medicine, Burlington, VT.
Correspondence to: John G. Stratidis, MD, Section of Infectious Diseases, Department of Medicine, Danbury Hospital, 24 Hospital Ave, Danbury, CT 06810. E-mail: firstname.lastname@example.org.
The authors have no funding or conflicts of interest to disclose.