Cutaneous Nocardia asteroides infection of nontraumatic origin

Lopes, Jorge O; Bassanesi, Maria C; Alves, Sydney H; Salla, Adenilde; Benevenga, Jeni P; Castro, Milton S.

doi:10.1590/S0036-46651994000500003

Abstracts

This paper reports a case of cutaneous infection of nontraumatic origin caused by Nocardia asteroides in a hospitalized patient with chronic obstructive pulmonary disease. Diagnosis was established by direct and histological examination, cultures from exudate and biopsy specimen. We discuss the classification of clinical forms of Nocardia infections affecting the skin.

Cutaneous infection; Chronic obstructive pulmonary disease; Nocardia asteroides; Nontraumatic origin

É relatado um caso de infecção cutânea de origem não traumática por Nocardia asteroides em paciente hospitalizado com doença broncopulmonar obstrutiva crônica. O diagnóstico foi feito pelo exame direto e histológico e culturas do exsudato e fragmento de biópsia. É discutida a classificação das formas clínicas das infecções por Nocardia que afetam a pele.

MICROBIOLOGY

Cutaneous Nocardia asteroides infection of nontraumatic origin

Infecção cutânea de origem não traumática por Nocardia asteroides

Jorge O. Lopes^I; Maria C. Bassanesi^II; Sydney H. Alves^I; Adenilde Salla^I; Jeni P. Benevenga^I; Milton S. Castro^I

^IServiço de Micologia, Hospital Universitário, Universidade Federal de Santa Maria, RS, Brasil

^IIServiço de Micologia, Instituto de Pesquisas Biológicas, Secretaria da Saúde e Meio Ambiente, Porto Alegre, RS, Brasil

^{Correspondence to} Correspondence to: Jorge O. Lopes Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria 97119-970 Santa Maria, RS, Brasil

SUMMARY

This paper reports a case of cutaneous infection of nontraumatic origin caused by Nocardia asteroides in a hospitalized patient with chronic obstructive pulmonary disease. Diagnosis was established by direct and histological examination, cultures from exudate and biopsy specimen. We discuss the classification of clinical forms of Nocardia infections affecting the skin.

Keywords: Cutaneous infection; Chronic obstructive pulmonary disease; Nocardia asteroides; Nontraumatic origin.

RESUMO

É relatado um caso de infecção cutânea de origem não traumática por Nocardia asteroides em paciente hospitalizado com doença broncopulmonar obstrutiva crônica. O diagnóstico foi feito pelo exame direto e histológico e culturas do exsudato e fragmento de biópsia. É discutida a classificação das formas clínicas das infecções por Nocardia que afetam a pele.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

ACKNOWLEDGEMENTS

The authors are indebted to Dr. Kathryn Bernard, National Laboratory for Bacteriology, Health and Welfare, Canada, for N. asteroides confirmatory identification.

Recebido para publicação em 20/12/1993.

Aceito para publicação em 29/03/1994.

1. ALTERAS, I. & FEURMAN, E.J. - The second case of mycetoma due to Nocardia caviae in Israel. Mycopathologia (Den Haag), 93: 185-187, 1986.
2. ARROYO, J.C.; NICHOLS, S. & CARROLL, G.F. - Disseminated Nocardia caviae infection. Amer. J. Med., 62: 409-412, 1977.
3. BEAMAN, B.L.; BURNSIDE, J.; EDWARDS, B. & CAUSEY, W. - Nocardial infections in the United States, 1972-1974. J. infect Dis., 134: 286-289, 1976.
4. BEAMAN, B.L.; BOIRON, P.; BEAMAN, L. et al. - Nocardia and nocardiosis. J. med. vet. Mycol., 30 (suppl. 1): 317-331, 1992.
5. BOIRON, P.; LAFAURIE, C.; RABBACHE, A. et al. - Urease-negative Nocardia asteroides causing cutaneous nocardiosis. J. clin. Microbiol., 28: 801-802, 1990.
6. CAUSEY, W.A.; ARNELL, P. & BRINKER, J. - Systemic Nocardia caviae infection. Chest, 65: 360-362, 1974.
7. CONTI-DIAZ, I.A. - Micetomas y procesos premicetomatosos en el Uruguay. Mycopathologia (Den Haag), 72: 59-64, 1980.
8. CURRY, W.A. - Human nocardiosis. A clinical review with selected case reports. Arch. intern. Med., 140: 818-826, 1980.
9. GUGNANI, H.C.; OJNKWU, J.O. & SUSEELAN, A.V. - Mycetoma of the thumb caused by Nocardia transvalemis. Mycopathologia (Den Haag), 80: 55-60, 1982.
10. HACHISUKA, H.; ICHIKI, M.; YOSHIDA, N.; NAKANO, S. & SASAI, Y. - Primary subcutaneous abscess caused by Nocardia otitidiscaviarum. J. Amer. Acad. Derm., 21: 137-139, 1989.
11. HAIM, S. & MERZBACH, D. - Primary chancriform syndrome caused by Nocardia asteroides. Mykosen, 22: 360-363, 1979.
12. HAY, R.J. - Nocardial infection of the skin. J. Hyg. (Lond.), 91: 385-391, 1983.
13. HIRUMA, N.; KAWADA, A.; ISHIBASHI, A. & MKAMI, Y. - Localized cutaneous nocardiosis in Japan. Mycopathologia (Den Haag), 117: 133-138, 1992.
14. LONDERO, A.T.; RAMOS, C.D. & MATTE, S.W. - Micetomas actinomicóticos no Rio Grande do Sul - relato de quatro casos. Mem. Inst. Oswaldo Cruz, 81: 73-77, 1986.
15. MACKINNON, J.E.; CONTI-DIAZ, I.A.; GEZUELE, E. & GIORDANO, M.H. - Nocardiosis linfangítica. Torax, 17: 84-86, 1968.
16. MAHVI, T. - Disseminated nocardiosis caused by Nocardia brasiliensis. First case report in the United States. Arch. Derm., 84: 426-431, 1964.
17. MOORE, M. & CONRAD, A.H. - Sporotrichoid nocardiosis caused by Nocardia brasiliensis. Arch. Derm., 95: 390-393, 1967.
18. MOORE, M.; LANE, C.W. & GAUL, L.E. - Nocardiosis of the knee by Nocardia brasiliensis. Arch. Derm., 70: 302-310, 1954.
19. PETRILLO, V.F.; SEVERO, L.C.; LONDERO, A.T. & PORTO, N.S. - Pulmonary nocardiosis. Report of the first two Brazilian cases. Mycopathologia (Den Haag), 66: 17-20, 1978.
20. RAICH, R.A.; CASEY, F. & HALL, W.H. - Pulmonary and cutaneous nocardiosis. Amer. Rev. resp. Dis., 83: 505-508, 1960.
21. RAPAPORT, J. - Primary chancriform syndrome caused by Nocardia brasiliensis. Arch. Derm., 93: 62-64, 1966.
22. RIPPON, J.W. - Nocardiosis. In: RIPPON, J.W. Medical Mycology. The pathogenic fungi and the pathogenic actinomycetes. 3. ed. Philadelphia, W.B. Saunders, 1988. p 53-68.
23. SANTAMARIA SABER, L.T.; FIGUEIREDO, J.F.C.; SANTOS, S.B. et al. - Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations. Rev. Inst Med. trop. S. Paulo, 35: 417-421, 1993.
24. SANYAL, M.; THAMMAYYA, A. & BASU, N. - Actinomycetoma caused by organisms of the Nocardia asteroides complex and closely related strains. Mykosen, 21: 109-121, 1978.
25. SHAPIRO, P.E. & GROSMAN, M.E. - Disseminated Nocardia asteroides with pustules. J. Amer. Acad. Derm., 20: 889-892, 1989.
26. SATTERWHITE, T.K. & WALLACE, R.J. - Primary cutaneous nocardiosis. J. Amer. med. Ass., 242: 333-336, 1979.
27. VASARINSH, P. - Primary cutaneous nocardiosis. Arch. Derm., 98: 489-493, 1968.
28. WARNOCK, D.W. - Introduction to the management of fungal infection in the compromised patient. In: WARNOCK, D.W. & RICHARDSON, M.D. Fungai infection in the compromised patient. 2. ed. West Sussex, John Wiley & Sons, 1991. p. 23-53.
29. WILSON, J.W. - Cutaneous (chancriform) syndrome in deep mycoses. Arch. Derm., 87: 121-125, 1963.
30. ZECLER, E.; GILBOA, Y.; ELKINA, L.; ATLAN, G. & SOMPOLINSKY, D. - Lymphocutaneous nocardiosis due to Nocardia brasiliensis. Arch. Derm., 113: 642-643, 1977.

Correspondence to:

Jorge O. Lopes

Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria

97119-970 Santa Maria, RS, Brasil

Publication Dates

Publication in this collection
21 Sept 2006
Date of issue
Oct 1994

History

Received
20 Dec 1993
Accepted
29 Mar 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALTERAS, I. & FEURMAN, E.J. - The second case of mycetoma due to Nocardia caviae in Israel. Mycopathologia (Den Haag), 93: 185-187, 1986.

[2] 2. ARROYO, J.C.; NICHOLS, S. & CARROLL, G.F. - Disseminated Nocardia caviae infection. Amer. J. Med., 62: 409-412, 1977.

[3] 3. BEAMAN, B.L.; BURNSIDE, J.; EDWARDS, B. & CAUSEY, W. - Nocardial infections in the United States, 1972-1974. J. infect Dis., 134: 286-289, 1976.

[4] 4. BEAMAN, B.L.; BOIRON, P.; BEAMAN, L. et al. - Nocardia and nocardiosis. J. med. vet. Mycol., 30 (suppl. 1): 317-331, 1992.

[5] 5. BOIRON, P.; LAFAURIE, C.; RABBACHE, A. et al. - Urease-negative Nocardia asteroides causing cutaneous nocardiosis. J. clin. Microbiol., 28: 801-802, 1990.

[6] 6. CAUSEY, W.A.; ARNELL, P. & BRINKER, J. - Systemic Nocardia caviae infection. Chest, 65: 360-362, 1974.

[7] 7. CONTI-DIAZ, I.A. - Micetomas y procesos premicetomatosos en el Uruguay. Mycopathologia (Den Haag), 72: 59-64, 1980.

[8] 8. CURRY, W.A. - Human nocardiosis. A clinical review with selected case reports. Arch. intern. Med., 140: 818-826, 1980.

[9] 9. GUGNANI, H.C.; OJNKWU, J.O. & SUSEELAN, A.V. - Mycetoma of the thumb caused by Nocardia transvalemis. Mycopathologia (Den Haag), 80: 55-60, 1982.

[10] 10. HACHISUKA, H.; ICHIKI, M.; YOSHIDA, N.; NAKANO, S. & SASAI, Y. - Primary subcutaneous abscess caused by Nocardia otitidiscaviarum. J. Amer. Acad. Derm., 21: 137-139, 1989.

[11] 11. HAIM, S. & MERZBACH, D. - Primary chancriform syndrome caused by Nocardia asteroides. Mykosen, 22: 360-363, 1979.

[12] 12. HAY, R.J. - Nocardial infection of the skin. J. Hyg. (Lond.), 91: 385-391, 1983.

[13] 13. HIRUMA, N.; KAWADA, A.; ISHIBASHI, A. & MKAMI, Y. - Localized cutaneous nocardiosis in Japan. Mycopathologia (Den Haag), 117: 133-138, 1992.

[14] 14. LONDERO, A.T.; RAMOS, C.D. & MATTE, S.W. - Micetomas actinomicóticos no Rio Grande do Sul - relato de quatro casos. Mem. Inst. Oswaldo Cruz, 81: 73-77, 1986.

[15] 15. MACKINNON, J.E.; CONTI-DIAZ, I.A.; GEZUELE, E. & GIORDANO, M.H. - Nocardiosis linfangítica. Torax, 17: 84-86, 1968.

[16] 16. MAHVI, T. - Disseminated nocardiosis caused by Nocardia brasiliensis. First case report in the United States. Arch. Derm., 84: 426-431, 1964.

[17] 17. MOORE, M. & CONRAD, A.H. - Sporotrichoid nocardiosis caused by Nocardia brasiliensis. Arch. Derm., 95: 390-393, 1967.

[18] 18. MOORE, M.; LANE, C.W. & GAUL, L.E. - Nocardiosis of the knee by Nocardia brasiliensis. Arch. Derm., 70: 302-310, 1954.

[19] 19. PETRILLO, V.F.; SEVERO, L.C.; LONDERO, A.T. & PORTO, N.S. - Pulmonary nocardiosis. Report of the first two Brazilian cases. Mycopathologia (Den Haag), 66: 17-20, 1978.

[20] 20. RAICH, R.A.; CASEY, F. & HALL, W.H. - Pulmonary and cutaneous nocardiosis. Amer. Rev. resp. Dis., 83: 505-508, 1960.

[21] 21. RAPAPORT, J. - Primary chancriform syndrome caused by Nocardia brasiliensis. Arch. Derm., 93: 62-64, 1966.

[22] 22. RIPPON, J.W. - Nocardiosis. In: RIPPON, J.W. Medical Mycology. The pathogenic fungi and the pathogenic actinomycetes. 3. ed. Philadelphia, W.B. Saunders, 1988. p 53-68.

[23] 23. SANTAMARIA SABER, L.T.; FIGUEIREDO, J.F.C.; SANTOS, S.B. et al. - Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations. Rev. Inst Med. trop. S. Paulo, 35: 417-421, 1993.

[24] 24. SANYAL, M.; THAMMAYYA, A. & BASU, N. - Actinomycetoma caused by organisms of the Nocardia asteroides complex and closely related strains. Mykosen, 21: 109-121, 1978.

[25] 25. SHAPIRO, P.E. & GROSMAN, M.E. - Disseminated Nocardia asteroides with pustules. J. Amer. Acad. Derm., 20: 889-892, 1989.

[26] 26. SATTERWHITE, T.K. & WALLACE, R.J. - Primary cutaneous nocardiosis. J. Amer. med. Ass., 242: 333-336, 1979.

[27] 27. VASARINSH, P. - Primary cutaneous nocardiosis. Arch. Derm., 98: 489-493, 1968.

[28] 28. WARNOCK, D.W. - Introduction to the management of fungal infection in the compromised patient. In: WARNOCK, D.W. & RICHARDSON, M.D. Fungai infection in the compromised patient. 2. ed. West Sussex, John Wiley & Sons, 1991. p. 23-53.

[29] 29. WILSON, J.W. - Cutaneous (chancriform) syndrome in deep mycoses. Arch. Derm., 87: 121-125, 1963.

[30] 30. ZECLER, E.; GILBOA, Y.; ELKINA, L.; ATLAN, G. & SOMPOLINSKY, D. - Lymphocutaneous nocardiosis due to Nocardia brasiliensis. Arch. Derm., 113: 642-643, 1977.

Brazil