Disseminated subcutaneous nocardiosis caused by Nocardia farcinica diagnosed by FNA biopsy and 16S ribosomal gene sequencing

Ronald M Angeles; Rocco P Lasala; Cristina V Fanning

doi:10.1002/dc.20804

Disseminated subcutaneous nocardiosis caused by Nocardia farcinica diagnosed by FNA biopsy and 16S ribosomal gene sequencing

Diagn Cytopathol. 2008 Apr;36(4):266-9. doi: 10.1002/dc.20804.

Authors

Ronald M Angeles¹, Rocco P Lasala, Cristina V Fanning

Affiliation

¹ Section of Cytopathology, Division of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. summa100@yahoo.com

PMID: 18335548
DOI: 10.1002/dc.20804

Abstract

Nocardia is an infrequent but significant cause of infections in the immunocompromised host. Clinical syndromes are varied and ranges from pulmonary, disseminated, cutaneous, and CNS involvement. Here we describe a case of disseminated subcutaneous nodules in a patient with multiple myeloma caused by Nocardia farcinica. The diagnosis was made by FNA biopsy which revealed gram positive filamentous bacilli in background of acute inflammation on smears. This was confirmed by 16S ribosomal gene sequencing. Prompt identification of N. farcinica is important because of its intrinsic resistance to broad spectrum cephalosporins and high risk of dissemination.

Publication types

Case Reports

MeSH terms

Aged
Anti-Infective Agents / administration & dosage
Anti-Infective Agents / pharmacology
Anti-Infective Agents / therapeutic use
Biopsy, Fine-Needle
Drug Resistance, Multiple, Bacterial
Gentian Violet
Humans
Male
Microbial Sensitivity Tests
Nocardia / drug effects
Nocardia / genetics
Nocardia / isolation & purification
Nocardia / physiology*
Nocardia Infections / diagnosis*
Nocardia Infections / drug therapy
Nocardia Infections / microbiology*
Phenazines
RNA, Ribosomal, 16S / genetics*
Sequence Analysis, DNA
Skin Diseases, Bacterial / diagnosis*
Skin Diseases, Bacterial / drug therapy
Skin Diseases, Bacterial / microbiology*
Skin Diseases, Bacterial / pathology
Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology
Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

Anti-Infective Agents
Gram's stain
Phenazines
RNA, Ribosomal, 16S
Trimethoprim, Sulfamethoxazole Drug Combination
Gentian Violet