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Lymphocutaneous Type of Nocardiosis Caused by Nocardia vinacea in a Patient with Polymyositis

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Abstract

We report a lymphocutaneous type of nocardiosis caused by Nocardia vinacea. A 62-year-old woman with polymyositis presented with some erythematous swellings and subcutaneous abscesses on her right middle finger and the dorsum of her hand, which had persisted for 2 weeks. Culturing of the excised nodule and pus revealed orange to orange-tan colonies with scanty whitish aerial mycelia. The isolate was identified as N. vinacea on the basis of its biochemical and chemotaxonomic characteristics and the results of molecular biological analysis. In our case, oral minocycline (MINO) and trimethoprim-sulfamethoxazole (TMP-SMX) for 7 weeks did not improve the clinical manifestation, even though in vitro susceptibility testing of the isolate predicted its susceptibility to MINO and TMP-SMX. Treatment with partial surgical excision followed by TMP-SMX and meropenem administration was effective. This is the first reported case of a lymphocutaneous type of nocardiosis caused by N. vinacea.

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Acknowledgments

We thank Mr. Masaharu Watanabe (Division of Laboratory Medicine, Chiba University Hospital) for technical assistance and Dr. Atsuhiro Suzuki (Shirogane Seikeigeka) for medical assistance.

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Authors and Affiliations

  1. Department of Dermatology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Mari T. Iwasawa, Yaei Togawa, Noriaki Kamada, Naotomo Kambe & Hiroyuki Matsue

  2. Medical Mycology Research Center, Chiba University, Chiba, Japan

    Katsukiyo Yazawa, Takashi Yaguchi & Yuzuru Mikami

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  1. Mari T. Iwasawa
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  2. Yaei Togawa
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  3. Noriaki Kamada
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  4. Naotomo Kambe
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  5. Hiroyuki Matsue
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  6. Katsukiyo Yazawa
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  7. Takashi Yaguchi
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  8. Yuzuru Mikami
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Correspondence to Mari T. Iwasawa.

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Iwasawa, M.T., Togawa, Y., Kamada, N. et al. Lymphocutaneous Type of Nocardiosis Caused by Nocardia vinacea in a Patient with Polymyositis. Mycopathologia 172, 47–53 (2011). https://doi.org/10.1007/s11046-011-9391-0

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  • DOI: https://doi.org/10.1007/s11046-011-9391-0

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