A Case of Localized Cutaneous Nocardiosis Caused by Trauma with a Rose Thorn

Abstract

A 72-year-old man who had been treated for hypertension and diabetes mellitus accidentally punctured the skin of his forearm with a rose thorn 3 months before he visited our hospital. He presented with a crusted infiltrative erythema of 2 cm diameter on the left forearm and no other symptoms. Cultures of biopsied skin tissue with Sabouraud dextrose agar slants revealed white-orange colonies with a smooth surface and wrinkles. Gram staining of the cultured microorganism revealed branched bacilli. These results strongly suggested cutaneous nocardiosis. The isolated strain was finally identified as Nocardia brasiliensis by tests conducted at the Medical Mycology Research Center of Chiba University. On the basis of these findings, the patient was diagnosed with localized cutaneous nocardiosis caused by Nocardia brasiliensis. The patient was cured in 6 weeks by treatment with oral minocycline.