Case Report
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World J Clin Infect Dis. Nov 25, 2013; 3(4): 86-89
Published online Nov 25, 2013. doi: 10.5495/wjcid.v3.i4.86
Primary lymphocutaneous nocardiosis associated with gardening: A case series
Giorgio Tarchini, Frederick S Ross
Giorgio Tarchini, Department of Infectious Disease, Cleveland Clinic Florida, Weston, FL 33331, United States
Frederick S Ross, Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL 33331, United States
Author contributions: Tarchini G took care of all patients, wrote the abstract, summary and discussion and proofread the manuscript; Ross FS took care of some of the patients, wrote the introduction and the description of the cases.
Correspondence to: Giorgio Tarchini, MD, Department of Infection Disease, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States. gtarchini@gmail.com
Telephone: +1-954-3993538 Fax: +1-954-6595166
Received: June 28, 2013
Revised: October 4, 2013
Accepted: November 2, 2013
Published online: November 25, 2013
Processing time: 151 Days and 23.2 Hours
Abstract

Most cases of nocardiosis are seen in immunocompromised patients. Primary lymphocutaneous is a relatively uncommon presentation of this disease that may also occurs in normal hosts. Diagnosing this infection requires a high index of suspicion since cultures can take several days to exhibit growth. The microbiology laboratory must therefore be notified about cases in which this pathogen is suspected. We report four cases of primary lymphocutaneous norcardiosis. Of particular interest is the association of three of these cases with gardening.

Keywords: Nocardia; Nocardiosis; Lymphocutaneous; Brasiliensis; Asteroides; Gardening

Core tip: Nocardiosis is an infection most often seen in immunocompromised individuals. In particular, primary cutaneous disease rarely occurs in normal hosts. We present a case series of patients that developed this infection after gardening. As nocardial infections are frequently mistaken for routine pyogenic processes and as routine cultures are rarely kept long enough to show growth, this condition should be considered in patients with such a history and cultures should be incubated for several weeks.