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. 2023 Jun;29(6):1266-1267.
doi: 10.3201/eid2906.221854.

Manifestations and Management of Trimethoprim/Sulfamethoxazole-Resistant Nocardia otitidiscaviarum Infection

Katherine Fu, Kyle White, Aliaksandr Ramaniuk, Vidya Kollu, Daniel Urbine

Manifestations and Management of Trimethoprim/Sulfamethoxazole-Resistant Nocardia otitidiscaviarum Infection

Katherine Fu et al. Emerg Infect Dis. 2023 Jun.

Abstract

Nocardia can cause systemic infections with varying manifestations. Resistance patterns vary by species. We describe N. otitidiscavarium infection with pulmonary and cutaneous manifestations in a man in the United States. He received multidrug treatment that included trimethoprim/sulfamethoxazole but died. Our case highlights the need to treat with combination therapy until drug susceptibilities are known.

Keywords: Nocardia; Nocardia otitidiscaviarum; United States; antimicrobial resistance; bacteria; chronic obstructive pulmonary disease; cutaneous abscess; drug resistance; trimethoprim/sulfamethoxazole.

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Figures

Figure
Figure
Pulmonary and cutaneous manifestations of Nocardia otitidiscavarium infection in a man in Gainesville, Florida, USA, 2020. A) Computed tomography of the chest showing progressive disease in the upper lobes. B) Bronchoalveolar lavage sample (Gram stain) showing gram-positive branching rods. C) Cutaneous abscess on the ulnar aspect of the right hand.
See this image and copyright information in PMC

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