顔面・頸部の皮膚リンパ型ノカルジア症例

抄録

Primary lymphocutaneous nocardiosis in the face and neck region appears to be rare in Japan. A 43-year-old woman presented with an erythematous papule at our clinic. Oral medication with FRPM was administered but, the pustule increased in size and the lesions spread to regional lymph nodes. Clinical examination revealed a 2×3cm induration with skin redness and a few small whitish pustules on the right side of the face and neck region. A general physical examination revealed no other abnormal findings. The laboratory investigation showed a white blood cell count of 9, 700 cells/μl, CRP 7.6mg/dl. After Nocardia was isolated from the aspirated pus, the patient was treated with sulfamethoxazole/trimethprim, minocycline. A CT scan revealed abscess foration in the right neck. An incision and drainage for the abscess was performed. The patient has remained asymptomatic for 15 months after discharge without medication.