Soil-acquired cutaneous nocardiosis on the forearm of a healthy male contracted in a swamp in rural eastern Virginia.

摘要: A 45-year-old man complained of pain and swelling on his right wrist after receiving a scratch while playing paintball in swampy area eastern Virginia. Two weeks later, he noticed pimple-like lesion developing, which quickly grew size then ulcerated. Because the severity condition, patient was taken to emergency room where surgical drainage abscess carried out pus sent for culture sensitivity testing. Enlarged tender lymph nodes were palpable going up arm surrounding axillary area. Three days following from lesion, colonies Nocardia brasiliensis isolated. He successfully treated with an extended regimen trimethoprim-sulfamethoxazole. its low incidence, nocardiosis is usually not considered initial diagnosis. The rapidity infection developed into extensive ulcerated area, involvement lymphatic system, time needed treat infection, potential rapidly disseminate, reinforces necessity laboratory identification immediate treatment severe pyogenic cutaneous lesions.