Diagnostic Dilemmas: Cutaneous Nocardiosis

Chad K. Wheeler, MD; Gary E. DeCesare, BS; Rudolph J. Mannari, PA-C; Wyatt G. Payne, MD; Martin C. Robson, MD


Wounds. 2005;17(5):131-136. 

In This Article


A 51-year-old man presented to the multidisciplinary wound clinic with right lower-extremity cellulitis and multiple open wounds of 6 months duration (Figure 1). His past medical history was significant for hypertension and insulin-dependent diabetes mellitus. Injured while gardening, his leg initially developed small punctures with surrounding contusions. As local erythema and edema evolved, the wounds became pustules and developed bullae. These chronic, worsening wounds opened and began draining, causing him to seek medical attention.

Nocardia brasiliensis cutaneous infection of 6 months duration involving the lower extremity. Multiple bullous abscesses are present.