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

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 b...

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Bibliographic Details
Published in:Diagnostic cytopathology 2008-04, Vol.36 (4), p.266-269
Main Authors: Angeles, Ronald M., LaSala, Rocco P., Fanning, Cristina V.
Format: Article
Language:English
Subjects:
16S ribosomal DNA sequencing
Aged
Anti-Infective Agents - administration & dosage
Anti-Infective Agents - pharmacology
Anti-Infective Agents - therapeutic use
Biopsy, Fine-Needle
Drug Resistance, Multiple, Bacterial
fine needle aspiration
Gentian Violet
Humans
Male
Microbial Sensitivity Tests
Nocardia - drug effects
Nocardia - genetics
Nocardia - isolation & purification
Nocardia - physiology
Nocardia farcinica
Nocardia Infections - diagnosis
Nocardia Infections - drug therapy
Nocardia Infections - microbiology
nocardiosis
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
subcutaneous
Trimethoprim, Sulfamethoxazole Drug Combination - administration & dosage
Trimethoprim, Sulfamethoxazole Drug Combination - pharmacology
Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
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Summary: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. Diagn. Cytopathol. 2008;36:266–269. © 2008 Wiley‐Liss, Inc.
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.20804