Thigh abscess due to Nocardia farcinica

Nocardia farcinica is an uncommon cause of nocardiosis and usually infects immunocompromised individuals. We describe a patient with Hodgkin's disease and a thigh abscess due to N. farcinica. To the best of our knowledge, this has never been reported before in the English literature. It is important to recognize this complication, because a delay in diagnosis may result in widespread dissemination. Unless initially suspected, culture and identification will be delayed, as selective media for isolating Nocardia are not routinely used in most clinical laboratories. It is also important to differentiate N. farcinica from other Nocardia species due to its resistance to many antibiotics that are routinely used to treat abscesses, including cephalosporins. A case report along with literature review is presented in an effort to stress the importance of including this pathogen in the differential diagnosis of immunocompromised patients with abscesses.