A unique case of fever with skin lesions

The incidence of Nocardiosis was c.1-2 per 100,000 population worldwide in the early 2000s. Co-infection with Nocardia and MOTT (mycobacterium other than tuberculosis) is even more uncommon and has been described only in the setting of pulmonary manifestations in an immunocompromised (HIV) patient. However, over the last two decades, the incidence of Nocardiosis has increased to about 7-8 per 100,000 population, with pulmonary manifestations being the most common. With this background, we present the case of a middle-aged immunosuppressed man (post renal transplant with rejection), who presented with fever with extensive skin lesions and features suggestive of sepsis, without pulmonary involvement.