Primary cutaneous Nocardia asteroides infection after heart transplantation

Skin diseases due to Nocardia are rare in Europe and usually occur as the secondary localization of a pulmonary lesion in immunocompromised patients. We describe a cutaneous pyoderma and cold abscess due to Nocardia asteroides infection in a cardiac transplant recipient. An insect bite represents the wound of this soil saprophyte belonging to the actinomycetes. Treatment by sulfone and ampicillin-clavulanic acid allowed the regression of lesions without extracutaneous dissemination.