Abstract
A 58-year-old woman, who had write infull (ITP) and angina, developed a rash similar to an insect bite on the left Achilles tendon one week before visiting our hospital. The rash evolved into pustule. Three or 4 days later she had redness and swelling on her left leg, which was pain full.
She went to a clinic, where she was given cefdinir (CFDN) and referred to our hospital.
When she came to our hospital, she had an abscess on her left heel, and linear redness and heat along lymph ducts in her left leg and lymph node swelling in her left groin.
We diagnosed bacterial lymphangitis, and gave her cefcapene (CFPN-PI) and gentamicin (GM) ointment. Six days later, she recovered.
Later abscess culture yielded an organism which was suspected to be Nocardia sp. We identified the organism as Nocardia brasiliensis and diagnosed abscess-type cutaneous nocardiosis. We administered sulfametthoxazole / trimethoprim for one week and checked her whole body on CT, which revealed no lesions.
This case was considered to be cutaneous nocardiosis, for which beta-lactam antimicrobial drug or external application of GM ointment would be effective, and abscess-type cutaneous nocardiosis, which recovered with medical treatment for a general bacterial infection was suggested.
