Abstract：
Nocardia spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestations of cutaneous disease are varied and frequently misdiagnosed. We present a case of an immunocompetent 66-year-old man who sustained a left finger injury while gardening. He was misdiagnosed on several occasions and treated with inappropriate antibiotics against Streptococcus spp. and Staphylococcus spp. When infection spread cutaneously, sporotrichoid (lymphocutaneous) nocardiosis was suspected and the patient was started on appropriate therapy with Bactrim which resulted in a cure. We also summarize the literature on lymphocutaneous infection by Nocardia brasiliensis. By reporting this case, we want to raise awareness among clinicians about unusual causes of cellulitis, the differential diagnosis of lymphocutaneous infection and the importance of obtaining a detailed exposure history to assist in the prompt diagnosis of nocardiosis.
摘要：
诺卡氏菌属。是革兰氏阳性，部分耐酸需氧细菌通常与免疫功能低下的人感染有关。最常见的感染部位是皮肤，肺,和大脑，然而，疾病可以传播和影响每个器官。皮肤病的临床表现多种多样，经常被误诊。我们介绍了一例有免疫能力的66岁男子，他在园艺时左指受伤。他多次被误诊，并接受了针对链球菌的不适当抗生素治疗。和葡萄球菌属。当感染在皮肤上传播时，怀疑有孢子囊（淋巴皮肤）诺卡尼病，患者开始接受Bactrim的适当治疗，从而治愈。我们还总结了有关巴西诺卡氏菌淋巴皮肤感染的文献。通过报告这个案子,我们希望提高临床医生对蜂窝织炎异常原因的认识，淋巴皮肤感染的鉴别诊断以及获得详细的暴露史以帮助迅速诊断诺卡心病的重要性。
