Purpose To report a rare case of lymphocutaneous Nocardia brasiliensis origina ting in the eyelid. Design Observational case report. Methods The clinical prese ntation, workup, and treatment of a case of lymphocutaneo...Purpose To report a rare case of lymphocutaneous Nocardia brasiliensis origina ting in the eyelid. Design Observational case report. Methods The clinical prese ntation, workup, and treatment of a case of lymphocutaneous Nocardia brasiliensi s originating in the eyelid are presented. Results The patient presentedwith a p reseptal cellulitis froman abrasion of the eyelid that progressed to submandibul ar lymph node suppuration. Culture was performed, and a diagnosis of lymphocutan eous Nocardia brasiliensis was made. Conclusion Nocardia brasiliensis may cause a lymphocutaneous infection of the face and must be considered in the differenti al diagnosis of preseptal cellulitis.展开更多
Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road ...Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine- cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. Case report. A 75 year- old woman fell on her right leg on the side of themain road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow- growing Gram- positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino- sensitive Staphylococcus aureus. The treatment with sulfamethoxazole- trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. Discussion. The revelation of this particular slow- growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations andwe discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective antibiotic drugs.展开更多
文摘Purpose To report a rare case of lymphocutaneous Nocardia brasiliensis origina ting in the eyelid. Design Observational case report. Methods The clinical prese ntation, workup, and treatment of a case of lymphocutaneous Nocardia brasiliensi s originating in the eyelid are presented. Results The patient presentedwith a p reseptal cellulitis froman abrasion of the eyelid that progressed to submandibul ar lymph node suppuration. Culture was performed, and a diagnosis of lymphocutan eous Nocardia brasiliensis was made. Conclusion Nocardia brasiliensis may cause a lymphocutaneous infection of the face and must be considered in the differenti al diagnosis of preseptal cellulitis.
文摘Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine- cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. Case report. A 75 year- old woman fell on her right leg on the side of themain road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow- growing Gram- positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino- sensitive Staphylococcus aureus. The treatment with sulfamethoxazole- trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. Discussion. The revelation of this particular slow- growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations andwe discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective antibiotic drugs.
