Nocardia species are soil-dwelling, Gram-positive, branching, beaded bacilli, and weakly positive to acid fast stain. It is estimated that there are approximately 500 to 1000 cases annually in the United States. The risk factors more commonly associated are transplantation, human immunodeficiency virus, underlying malignancy, chronic pulmonary disease, or steroid use. The organs more commonly affected by Nocardia species are the lungs, skin, or central nervous system, and the treatment usually consists in the administration of trimethoprim-sulfamethoxazole for a long period (3 to 12 months). Herein, we report a case of disseminated nocardiosis by Nocardia brasiliensis in a patient with Goodpasture disease. The presentation is unique in the sense that Nocardia brasiliensis is usually associated with only cutaneous involvement. However, this patient presented with pneumonia as well as pyomyositis. He received treatment with trimethoprim-sulfamethoxazole for 6 months. Eventually, he received a renal transplant and has remained on chronic immunosuppression with no evidence of recurrent nocardiosis. To date, few articles have been published regarding cases of pyomyositis secondary to Nocardia.
From the Divisions of *Infectious Diseases and †Internal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Correspondence to: Colleen S. Kraft, MD, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Emory University Hospital, 1364 Clifton Rd, Atlanta, GA 30322. E-mail: firstname.lastname@example.org.
The authors have no funding or conflicts of interest to disclose.
SA was the main writer of the manuscript. CK and NS managed the patient. CK and NS moderated the manuscript. All authors read and approved the final manuscript.