A case of disseminated cutaneous nocardiosis due to Nocardia brasiliensis diagnosed by fine needle aspiration biopsy and 16s ribosomal RNA sequencing

Nocardiosis is a rare, life-threatening infection in the immunocompromised host. The causative bacteria are members of the genus Nocardia and are filamentous gram-positive bacilli that usually infect the lung, skin, and central nervous systems. Cutaneous nocardiosis presents as a disseminated infection or as a primary infection resulting from inoculation. Isolation of Nocardia from clinical specimens and identification of species is difficult and needs the expertise of a microbiologist. These infections are particularly important because of the associated high risk of dissemination. Hence, prompt identification of this organism is crucial. Herein we report a case of disseminated nocardiosis caused by N. brasiliensis in a 64-year-old man diagnosed by fine needle aspiration (FNA) and 16S ribosomal RNA sequencing. The patient was treated with trimethoprim plus sulfamethoxazole, imipenem, and amikacin with an improvement of symptoms.