Nocardia veterana infections: case report and systematic review

Abstract

Members of the genus Nocardia are filamentous, Gram-positive, aerobic bacteria and exist ubiquitously in most environments. In 2001, the species Nocardia veterana was first isolated, and it predominantly causes pulmonary infections in immunocompromised hosts. We present the first report of a soft-tissue abscess caused by N. veterana in a 59-year-old woman being treated for chronic cutaneous graft-versus-host disease. After failing to improve with empirical treatment, two incision and drainage procedures were required. She subsequently completed a 1-year course of oral antibiotic therapy consisting of trimethoprim-sulfamethoxazole then azithromycin. No relapse occurred over the next 5 years of follow up. To better characterize N. veterana infections, we performed a systematic literature review and summarized all previously reported cases. Overall, the rising prevalence of immunocompromising conditions warrants increased vigilance for infections caused by atypical or opportunistic pathogens.

Keywords: Abscess; Nocardia veterana; graft-versus-host disease; nocardiosis; trimethoprim-sulfamethoxazole.

Fig. 1

Nocardia veterana abscess: T2-weighted magnetic resonance imaging demonstrates 2-cm abscess involving the superficial fascia of the right lateral deltoid muscle.