By far the most common clinical manifestation of Nocardia brasiliensis infection is mycetoma, a chronic localized infection of the subcutaneous tissue.1-3 Although extension of the mycetoma to contiguous tissues may occur, dissemination to distant sites is extremely rare.2 This contrasts sharply with Nocardia asteroides infection, which usually begins in the lung and often spreads to distant sites.4,5 The fact that N brasiliensis infection may behave clinically like that due to N asteroides is illustrated by the following patient history. Unlike a previously reported instance of disseminated N brasiliensis infection,6 this patient had no detectable pneumonitis, but had multiple cutaneous lesions and genitourinary tract infection.
A 65-year-old Italian male cement worker from New York was admitted in mid-1962 for evaluation and treatment of systemic lupus erythematosus. Treatment included varying doses of prednisone ranging from 10 to 25 mg/day depending on disease activity, in addition to
Diamond RD, Bennett JE. Disseminated Nocardia brasiliensis Infection. Arch Intern Med. 1973;131(5):735-736. doi:10.1001/archinte.1973.00320110119019