A case report of Nocardia cyriacigeorgica presenting as cellulitis with multiple discharging sinuses

Nocardia spp. are filamentous Gram positive bacteria that are ubiquitous soil saprophytes. The majority of nocardial infections occur in severely immunocompromised patients who are particularly susceptible to pulmonary disease and dissemination. Extrapulmonary nocardiosis is relatively common and can occur through hematogenous dissemination or a contiguous spread of necrotizing pneumonitis. Primary cutaneous and soft tissue nocardiosis can result from traumatic injury to the skin that involves contamination with soil. After skin inoculation, a superficial abscess or localized cellulitis can develop. Co-trimoxazole is the drug of choice for all types of nocardiosis. We are reporting a case of Nocardia cyriacigeorgica presenting as cellulitis followed tooth extraction.

Long-term treatment of persistent disseminated Nocardia cyriacigeorgica infection

In this paper a disseminated persistent Nocardia cyriacigeorgica infection in an immunocompetent patient is described. The patient's long-term treatment, as well as its implications for managing similar cases in the future, is emphasized. Presenting with high fever, multiple nodules, and ulcerative cutaneous lesions of body sites, the patient was treated with various antimicrobials. Under combined therapy, empyema and arthritis, leading to disseminated nocardiosis, were seen. The overall treatment course was 28 months. It can be concluded that the choice of the antibiotics and optimal duration of treatment are uncertain; therefore the treatment of nocardiosis requires expertise.

Primer reporte de infección natural por Nocardia cyriacigeorgica en ratones BALB/c / First report of a natural infection by Nocardia cyriacigeorgica in BALB/c mice

Las bacterias del género Nocardia son actinomicetos aerobios cuyo hábitat es el suelo y la materia orgánica en descomposición. La infección natural por especies de este género ha sido reportada en humanos y animales, sin embargo, la infección natural en ratones no ha sido descrita. En este estudio se demuestra por primera vez el aislamiento de la especie recientemente descrita, Nocardia cyriacigeorgica, en pulmones de ratones Balb/c. El estudio microbiológico de las muestras de pulmón reportó la presencia de filamentos grampositivos ramificados fragmentados en forma cocobacilares. Los estudios de PCR demostraron que la especie aislada fue N. cyriacigeorgica. Se evidencia en este trabajo que N. cyriacigeorgica es potencialmente patógena en ratones Balb/c.

Bacteria belonging to the Nocardia genus are aerobic actinomycetae whose habitat is the ground and decomposing organic material. Natural infection by species belonging to this genus has been reported in humans and animals; nevertheless, natural infection in mice has not been described until now. This study demonstrates for the first time the isolation of a recently described species, Nocardia cyriacigeorgica, rom the lungs of Balb/c mice. The microbiological study of the lung samples reported the presence of branched Gram positive filaments with a cocobacillar shape. PCR studies demonstrated that the species isolated was N. cyriacigeorgica. This study demonstrates that N. cyriacigeorgica is potentially pathogenic for Balb/c mice.

A Strain of Nocardia cyriacigeorgica Isolated from a Patient with Pulmonary Infection / 대한임상미생물학회지

Nocardia cyriacigeorgica is an aerobic gram-positive rod that has mostly been reported as an opportunistic pathogen. Since molecular methodologies were introduced to identify species, infections caused by N. cyriacigeorgica have been reported. The patient was a 51-year-old woman with aplastic anemia, systemic lupus erythematosus, and disseminated tuberculosis, who was admitted to Chosun University Hospital with a history of fever and productive cough. During her hospitalization, sputum cultures were taken and a bacterium suspicious of acitinomycetes grew five times. It was a gram-positive rod that was also partially acid-fast on modified Kinyoun stain and resistant to lysozyme. After 24 h of incubation, cultures of the sputum onto sheep's blood agar plates (BAP) demonstrated rough, chalky, and white colonies with a characteristic earthy odor. Based on the above results, the presumptive identification of Nocardia species was made. To identify species of this isolate, 16S rRNA gene sequence analysis was taken and showed 99.9% homology to N. cyriacigeorgica DSM44484(T). The results of biochemical tests were compatible with other reports of N. cyriacigeorgica. As a result, this isolate was identified as N. cyriacigeorgica. Herein, we present a first report of N. cyriacigeorgica isolated from a patient with pulmonary infection in Korea.