Disseminated Nocardia farcinica infection in an AIDS patient

This report describes an AIDS patient presenting with disseminated Nocardia farcinica infection diagnosed by percutaneous kidney biopsy. The isolate was initially identified as Nocardia asteroides. Though Nocardia asteroides remains sensitive to most antimicrobial agents, Nocardia farcinica is resistant to gentamicin, tobramycin and cephalosporins and is indistinguishable from Nocardia asteroides by regular laboratory methods. In view of the rising incidence of infections with Nocardia farcinica, third-generation cephalosporins should not be used in the initial management of Nocardia infections, and all isolates should be submitted for antibiotic susceptibility testing.