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CASE REPORT
  
Year : 1993  |  Volume : 59  |  Issue : 1  |  Page : 37-38

Spontaneous remission of primary cutaneous nocardiosis

Rama Ramani, Girij Kumari 
 

Correspondence Address:
Rama Ramani


Abstract

Nocardia Brasiliensis involves the skin and subcutaneous tissue often. We report spontaneous remission of a case of primary cutaneous nocardiosis for its rarity.



How to cite this article:
Ramani R, Kumari G. Spontaneous remission of primary cutaneous nocardiosis.Indian J Dermatol Venereol Leprol 1993;59:37-38


How to cite this URL:
Ramani R, Kumari G. Spontaneous remission of primary cutaneous nocardiosis. Indian J Dermatol Venereol Leprol [serial online] 1993 [cited 2019 Sep 18 ];59:37-38
Available from: http://www.ijdvl.com/text.asp?1993/59/1/37/3878


Full Text

 Introduction



Infection caused by Nocardia organisms are increasing in number. [1] Two species of Nocardia namely No. asteroides and No. brasiliensis play a major pathogenic role. No. asteroides is capable of producing a spectrum of illness involving the pulmonary system, central nervous system, and disseminated form of nocardiosis. However, No. brasiliensis frequently involves the skin and subcutaneous tissue. [2]

We report spontaneous healing of primary cutaneous nocardiosis in a 22-year-old man.

 Case Report



A 22-year-old man, agriculturist, developed skin lesions 5 years ago. To start with, the lesion was small and there was redness, oozing, and crusting. Examination revealed a linear plaque with surrounding hyperpigmentation measuring 10 cm x 4 cm on the right shin. There were no other lesions present elsewhere on the body. The haemogram, urine analysis, and chest X-ray were normal. There was no associated fever. Culture for pyogenic organisms from these lesions was sterile. A provisional diagnosis of sporotrichosis was made. The tissue was sent for fungus culture and histopathological examination. Biopsy was non- contributory, while the culture on Sabouraud's dextrose agar grew No. brasiliensis, which was confirmed by biochemical reactions. After 4 weeks the lesions resolved with hyperpigmentation.

 Comments



Pustules, cellulitis, pyoderma, and lymphocutaneous form of nocardiosis are encountered. [3] The lymphocutaneous or sporotrichoid form of infection is an unusual form of cutaneous nocardiosis. [4] Starting as a local pyodermatous lesion, spreading in a linear fashion as seen in our case, mimicing the lymphocutaneous disease of Sporothrix schenckii. Most cases of cutaneous nocardial infection are associated with a predisposing condition of trivial injury, most commonly seen in gardeners.

Culture of the tissue is confirmatory as lymphocutaneous nocardiosis resembles sporotrichum infection. Nacardia organisms are susceptible to sulfonamide therapy.

However in our case, sulfonamide therapy was not given as sporotrichosis was suspected. Spontaneous remission is known in sporotrichosis [5] but rarely reported in nocardiosis. Immune-competence may play a role in spontaneous healing, as seen in our patient.

References

1Murray JF, Finegold SM, Froman S,et al. The changing spectrum of nocardiosis. Am Rev Respir Dis 1961 ; 83: 315-30.
2Satterwhite TK, Wallace RJ Jr. Primary cutaneous nocardiosis.JAMA 1979; 242: 333-6.
3Moove M, Conrad AH, Sporotrichoid nocardiosis caused by Nocardia brasiliensis. Arch Dermatol 1976, 95: 390-3.
4Belliveau RR, Geiger F. Lymphocutaneous Nocardia brasiliensis infection simulating . sporotrichosis. West J Med 1977; 127: 245-6.
5Ramani R, Balachandran C, Shivananda PG, et al.. Spontaneous remission of cutaneous sporotrichosis. Ind J Pathol Microbiol 1991 ;34: 288-9.

 

Wednesday, September 18, 2019
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