A case report of Nocardia cyriacigeorgica presenting as cellulitis with multiple discharging sinuses

Area of Science:

• Microbiology
• Infectious Diseases
• Dermatology

Background:

• Nocardia species are Gram-positive bacteria found in soil, causing infections mainly in immunocompromised individuals.
• Nocardiosis can manifest as pulmonary disease or extrapulmonary infections through various dissemination routes.
• Cutaneous nocardiosis often results from skin trauma and soil contamination, leading to abscesses or cellulitis.

Observation:

• This report details a rare case of Nocardia cyriacigeorgica infection.
• The infection presented as cellulitis, a common skin manifestation.
• The onset of cellulitis was observed following a tooth extraction procedure.

Findings:

• Nocardia cyriacigeorgica was identified as the causative agent.
• The clinical presentation mimicked typical cellulitis.
• The case highlights a potential, albeit uncommon, association between dental procedures and nocardial skin infections.

Implications:

• This case expands the known clinical spectrum of Nocardia cyriacigeorgica infections.
• It underscores the importance of considering nocardiosis in patients with cellulitis, especially after procedures with potential for microbial inoculation.
• Co-trimoxazole is confirmed as the treatment of choice for Nocardia infections, including this specific presentation.