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Primary cutaneous nocardiosis

M Folgaresi¹, G Ferdani, M Coppini

¹Department of Dermatology, University of Modena, Via del Pozzo 71, 41100, Modena, Italy.

European Journal of Dermatology : EJD

|September 5, 1998

Summary

A patient with systemic lupus erythematosus developed a rare skin infection, primary cutaneous nocardiosis. Treatment with imipenem successfully cleared the infection, showing its effectiveness in managing this condition.

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Area of Science:

Dermatology
Infectious Diseases
Microbiology

Background:

Systemic lupus erythematosus (SLE) is an autoimmune disease often managed with long-term immunosuppressive therapy, such as oral corticosteroids.
Patients on chronic immunosuppression are at increased risk for opportunistic infections.
Primary cutaneous nocardiosis is a rare bacterial infection affecting the skin, caused by Nocardia species.

Observation:

A 37-year-old female patient with a 10-year history of SLE treated with oral corticosteroids presented with symptomatic skin lesions.
The lesions manifested as brown-violaceous, suppurative nodules and plaques on her right leg.
Microbiological cultures from skin biopsies confirmed the presence of Nocardia species.

Findings:

The patient was treated with intravenous imipenem (500 mg three times daily).
Complete regression of the cutaneous lesions was observed within two months of initiating imipenem therapy.
Clinical follow-up at 6 months revealed no recurrence of the infection.

Implications:

This case highlights the importance of considering rare infections like primary cutaneous nocardiosis in immunocompromised patients.
Imipenem demonstrates significant efficacy in treating primary cutaneous nocardiosis, leading to rapid clinical improvement.
Prompt diagnosis and appropriate antibiotic therapy are crucial for successful management and preventing complications in such cases.

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