From Suppurative Inflammation to Fibrotic Remodeling in Cutaneous Nocardiopsis Infection.
Naixuan Lin, Keke Huang, Degang Yang
✦ AI-curated · Sources linked
Case in brief
A 77-year-old woman with hypertension and diabetes presented with ulcerated purplish-red nodules on her lower extremities, present for 3 months. Biopsy showed infectious granulomas composed predominantly of neutrophils. Empirical antibiotics were ineffective; polymerase chain reaction, gene sequencing, and microbial culture identified Nocardiopsis sp. TSRI0078. After treatment with oral trimethoprim-sulfamethoxazole, the lesions gradually regressed, leaving scars.
What made this case unusual
The infection presented as chronic ulcerated nodules with neutrophil-predominant granulomas, and the causative organism was a rare actinomycete, Nocardiopsis sp. TSRI0078.
Diagnostic / clinical pearl
For chronic, unexplained cutaneous lesions, consider Nocardiopsis infection; combining molecular testing with conventional microbiological methods can help establish the diagnosis.