RESUMEN
Neorickettsia helminthoeca (NH), the agent of salmon poisoning disease or canine neorickettiosis (CN), is a bacterial endosymbiont of the nematode Nanophyetus salmincola, and infections are spreading among specific fish-eating mammalians. This article describes the pathologic and immunohistochemical findings associated with spontaneous NH-induced infections in dogs from Southern Brazil. The principal pathologic findings were hypertrophy of Peyer patches and lymphadenopathy with lymphocytic proliferation, chronic interstitial pneumonia, and chronic enteritis associated with positive intralesional immunoreactivity to antigens of NH within macrophages and histiocytes. Positive immunoreactivity against canine parvovirus-2 (CPV-2) or/and canine distemper virus was not detected in the evaluated intestinal segments or in the samples from the cerebellum and lungs, respectively, from the dogs evaluated. These findings demonstrated that NH was involved in the enteric, pulmonary, and lymphoid lesions herein described, and provide additional information to confirm the occurrence of this bacterial endosymbiont within this geographical location. It is proposed that chronic pneumonia should be considered as a pathologic manifestation of NH-induced infections. Additionally, our results show that the occurrences of CN seem to be underdiagnosed in Southern Brazil due to the confusion with the incidence of CPV-2.
Asunto(s)
Infecciones por Anaplasmataceae/veterinaria , Enfermedades de los Perros/microbiología , Gastroenteritis/veterinaria , Enfermedades Pulmonares/veterinaria , Enfermedades Linfáticas/veterinaria , Neorickettsia/aislamiento & purificación , Animales , Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Antígenos Bacterianos/inmunología , Brasil/epidemiología , Reacciones Cruzadas , Virus del Moquillo Canino/inmunología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/inmunología , Perros , Femenino , Gastroenteritis/epidemiología , Gastroenteritis/inmunología , Gastroenteritis/microbiología , Inmunohistoquímica , Enfermedades Pulmonares/epidemiología , Enfermedades Pulmonares/inmunología , Enfermedades Pulmonares/microbiología , Enfermedades Linfáticas/epidemiología , Enfermedades Linfáticas/inmunología , Enfermedades Linfáticas/microbiología , Masculino , Neorickettsia/inmunología , Parvovirus Canino/inmunología , SimbiosisRESUMEN
Sporotrichosis is a common subcutaneous mycosis in Latin America, produced by dimorphic fungi belong to Sporothrix schenckii complex of cryptic species. Infection is acquired by traumatic inoculation with contaminated organic material. Host immune response includes polymorphonuclear neutrophils chemotaxis and release of granular components. Lactoferrin is a protein member of the transferrin family of iron-binding proteins, present inside polymorphonuclear granular structure, and has been reported to affect growth and development of infectious agents, including fungal organisms. Nevertheless, lactoferrin expression in sporotrichosis infections has not been reported yet. OBJECTIVE: To determine the expression of lactoferrin using immunohistochemical staining in sporotrichosis human infection. MATERIAL AND METHODS: The dermatology department's files during a period of five years were reviewed; cases with a diagnosis of sporotrichosis were selected and lactoferrin immunostaining was performed when enough biological material was available. RESULTS: Three cases with a diagnosis of sporotrichosis and adequate biological material on paraffin block were identified. In all cases, lactoferrin immunostaining was positive around yeast cell.
Asunto(s)
Lactoferrina/metabolismo , Enfermedades Linfáticas/metabolismo , Esporotricosis/metabolismo , Linfocitos T CD4-Positivos , Humanos , Inmunidad Celular , Lactoferrina/análisis , Enfermedades Linfáticas/inmunología , Enfermedades Linfáticas/microbiología , Sporothrix , Esporotricosis/inmunología , Esporotricosis/transmisiónRESUMEN
Disseminated histoplasmosis (DH) is the most current revelation mode of AIDS in French Guiana. We describe the clinical and paraclinical presentation of DH, diagnostic tools, evolution and factors associated with 1-year mortality in HIV-infected patients from western French Guiana. Microbiologically proven AIDS-related DH in Saint Laurent du Maroni's hospital between May 2002 and May 2012 were retrospectively included. Among the 82 patients included, 58 (71%) were male, 44 (53%) presented concurrent histoplasmosis and HIV diagnosis and 63 (80%) had a CD4 cell count under 50 cells µL(-1). Almost all patients had weight loss (97%) and fever (95%), while 84% had digestive symptoms (63% diarrhoea), 55% lymphadenopathy, and 49% respiratory symptoms. Documented and presumed locations of H. capsulatum var capsulatum (Hcc) concerned almost all organs, with a particular affinity for the bone marrow and the digestive system. Co-infections were associated in 65%. Following treatment initiation, 10 patients (13%) died within 1 month and 17 patients (25%) died within a year. DH is a polymorphous systemic mycosis with haematological and digestive tropism. Co-infections are frequent and mortality rate is high.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Histoplasma/aislamiento & purificación , Histoplasmosis , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Adulto , Médula Ósea/microbiología , Recuento de Linfocito CD4 , Coinfección , Diarrea , Femenino , Fiebre , Guyana Francesa , Tracto Gastrointestinal/microbiología , Histoplasmosis/diagnóstico , Histoplasmosis/mortalidad , Humanos , Enfermedades Linfáticas/microbiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Pérdida de PesoRESUMEN
Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
Asunto(s)
Ascomicetos/aislamiento & purificación , Eritema Nudoso/complicaciones , Lepra Lepromatosa/complicaciones , Enfermedades Linfáticas/microbiología , Micosis/microbiología , Ascomicetos/genética , Humanos , Enfermedades Linfáticas/complicaciones , Masculino , Micosis/complicaciones , Adulto JovenRESUMEN
Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
Asunto(s)
Humanos , Masculino , Adulto Joven , Ascomicetos/aislamiento & purificación , Eritema Nudoso/complicaciones , Lepra Lepromatosa/complicaciones , Enfermedades Linfáticas/microbiología , Micosis/microbiología , Ascomicetos/genética , Enfermedades Linfáticas/complicaciones , Micosis/complicacionesRESUMEN
Paracoccidioidomycosis (PCM) is a severe systemic mycosis, endemic in Latin America and highly prevalent in Brazil, where it ranks eighth as a mortality cause among infectious and parasitic diseases in humans. The disease in animals has been little explored. It is observed that armadillos can harbor the fungus at high frequencies, although the active disease has not been well documented in this wild mammal. Dogs are susceptible to experimental infection, and the naturally acquired PCM-disease was reported only recently in a dog from Brazil. The present work reports the second case of naturally acquired PCM in a 6-year-old female dog that presented emaciation, lymphadenomegaly, and hepatosplenomegaly. Biochemical and pulmonary radiographic evaluation did not reveal any abnormalities. PCM was diagnosed by clinical findings, culturing, immunohistochemistry, and histopathology of popliteal lymph node. The fungus was recovered from popliteal lymph node, and the molecular analysis showed respective sequencing similarities of 99 and 100% for 803 nucleotides of the Gp43 gene and 592 nucleotides from the ITS-5.8S region of Paracoccidioides brasiliensis. Immunohistochemistry revealed severe lymphadenitis and presented numerous yeasts, which reacted against the gp43 antibody. Histopathology revealed a severe granulomatous lymphadenitis associated with numerous single or multiple budding yeasts. After diagnosis, the dog was successfully treated with itraconazol for 2 years. Veterinarians should be aware of the importance of considering PCM for differential diagnosis, especially in dogs from PCM-endemic areas, whose monophagocytic system involvement is evident.
Asunto(s)
Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/patología , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/patología , Paracoccidioides/aislamiento & purificación , Paracoccidioidomicosis/veterinaria , Animales , Antifúngicos/administración & dosificación , Brasil , ADN de Hongos/química , ADN de Hongos/genética , ADN Ribosómico/química , ADN Ribosómico/genética , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Enfermedades de los Perros/diagnóstico , Perros , Femenino , Proteínas Fúngicas/genética , Histocitoquímica , Inmunohistoquímica , Itraconazol/administración & dosificación , Ganglios Linfáticos/patología , Enfermedades Linfáticas/tratamiento farmacológico , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/tratamiento farmacológico , Paracoccidioidomicosis/patología , ARN Ribosómico 5.8S/genética , Análisis de Secuencia de ADN , Resultado del TratamientoAsunto(s)
Enfermedades Linfáticas , Nocardiosis , Enfermedades Cutáneas Bacterianas , Humanos , Inmunocompetencia , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/microbiología , Masculino , Persona de Mediana Edad , Nocardiosis/diagnóstico , Enfermedades Cutáneas Bacterianas/diagnósticoRESUMEN
Nocardiosis is a mixed suppurative and granulomatous inflammatory disease caused by infection with Nocardia organisms, a group of aerobic actinomycetes. We recently encountered a 25-year-old woman with posttraumatic nocardiosis of the lower extremities. The clinical symptoms noted during her first visit included erythematous swelling of the right knee accompanied by white maceration of the center of the knee and erosions, shallow ulcers and satellite pustules. In addition, multiple erythematous areas (up to the size of the tip of the thumb) were linearly distributed on the right thigh. These lesions were painful, and right inguinal lymphadenopathy was also noted. No lesion was found in internal organs such as the lungs. Histopathologically, signs of nonspecific granulomatous inflammation were observed, as well as several filamentous branching bacilli positive on Grocott stain. The organisms isolated from culture of pus were acid-fast, Gram-positive long rods. The isolated strain was finally identified as Nocardia brasiliensis. The patient was therefore diagnosed with lymphocutaneous type of primary cutaneous nocardiosis caused by N. brasiliensis. Drip infusion of flomoxef sodium was initially performed to treat her condition. Because of exacerbation of erythematous swelling of the right knee and an increase in number of pustules, treatment was switched to oral minocycline hydrochloride therapy. The disease healed 9 weeks after the start of oral minocycline hydrochloride therapy. Our patient was free of systemic immunosuppression and was neither under 10 nor over 65 years of age. She may therefore be considered a rare case of lymphocutaneous type of nocardiosis. We present this case and discuss reported cases of primary cutaneous nocardiosis due to N. brasiliensis in Japan.
Asunto(s)
Enfermedades Linfáticas/patología , Nocardiosis/patología , Nocardia/aislamiento & purificación , Enfermedades Cutáneas Bacterianas/patología , Piel/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Niño , Preescolar , Femenino , Humanos , Japón/epidemiología , Enfermedades Linfáticas/tratamiento farmacológico , Enfermedades Linfáticas/microbiología , Persona de Mediana Edad , Minociclina/uso terapéutico , Nocardia/crecimiento & desarrollo , Nocardiosis/tratamiento farmacológico , Nocardiosis/epidemiología , Nocardiosis/microbiología , Piel/lesiones , Piel/microbiología , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/epidemiología , Enfermedades Cutáneas Bacterianas/microbiología , Infección de Heridas/microbiologíaRESUMEN
A paracoccidioidomycosis case in a four-year old boy, with fever, lymphadenopathy and hepatosplenomegaly is presented. The diagnosis was confirmed by serology and lymph node biopsy. The patient was treated with amphotericin B. After 48 hours, clinical improvement and considerable adenopathies remission were observed.
Asunto(s)
Paracoccidioidomicosis/diagnóstico , Biopsia , Preescolar , Fiebre/etiología , Hepatomegalia/etiología , Humanos , Enfermedades Linfáticas/etiología , Enfermedades Linfáticas/microbiología , Masculino , Paracoccidioides/aislamiento & purificación , Paracoccidioidomicosis/tratamiento farmacológico , Paracoccidioidomicosis/microbiología , Paracoccidioidomicosis/patología , Esplenomegalia/etiologíaAsunto(s)
Traumatismos de los Dedos/complicaciones , Dermatosis de la Mano/microbiología , Enfermedades Linfáticas/etiología , Nocardiosis/diagnóstico , Infección de Heridas/microbiología , Absceso/tratamiento farmacológico , Absceso/etiología , Absceso/cirugía , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Antibacterianos/uso terapéutico , Terapia Combinada , Desbridamiento , Femenino , Jardinería , Dermatosis de la Mano/tratamiento farmacológico , Dermatosis de la Mano/cirugía , Humanos , Enfermedades Linfáticas/tratamiento farmacológico , Enfermedades Linfáticas/microbiología , Persona de Mediana Edad , Nocardia/aislamiento & purificación , Nocardiosis/tratamiento farmacológico , Nocardiosis/etiología , Nocardiosis/microbiología , Nocardiosis/cirugía , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/cirugíaRESUMEN
PURPOSE: To report a rare case of lymphocutaneous Nocardia brasiliensis originating in the eyelid. DESIGN: Observational case report. METHODS: The clinical presentation, workup, and treatment of a case of lymphocutaneous Nocardia brasiliensis originating in the eyelid are presented. RESULTS: The patient presented with a preseptal cellulitis from an abrasion of the eyelid that progressed to submandibular lymph node suppuration. Culture was performed, and a diagnosis of lymphocutaneous Nocardia brasiliensis was made. CONCLUSION: Nocardia brasiliensis may cause a lymphocutaneous infection of the face and must be considered in the differential diagnosis of preseptal cellulitis.
Asunto(s)
Infecciones Bacterianas del Ojo/microbiología , Enfermedades de los Párpados/microbiología , Enfermedades Linfáticas/microbiología , Nocardiosis/microbiología , Nocardia/aislamiento & purificación , Enfermedades Cutáneas Bacterianas/microbiología , Anciano , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Enfermedades de los Párpados/diagnóstico , Enfermedades de los Párpados/tratamiento farmacológico , Humanos , Ganglios Linfáticos/microbiología , Ganglios Linfáticos/patología , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/tratamiento farmacológico , Masculino , Nocardiosis/diagnóstico , Nocardiosis/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
To establish the frequency of infectious aetiology in Mexican adult patients with cervical lymphadenopathies (CLAs), 87 consecutive patients with enlarged cervical lymphatic nodes, HIV negative and without anti-tuberculous treatment, were selected from a tertiary-level speciality concentration hospital. Histopathological studies, investigation of acid-fast bacilli, cultures in Löwenstein Jensen and Mycobacterium growth indicator tube (MGIT) media, and in-house polymerase chain reaction (PCR) with IS6110-based primers for Mycobacterium tuberculosis complex were performed in resected lymphatic nodes. Non-infectious aetiology corresponded to 45 cases (52 %). Tuberculosis was suspected in 42 cases (48%) by histology and confirmed positive results were obtained by staining in 8 (19%), by culture in 23 (55%), and by PCR in 34 (81 %) patients. All were confirmed after therapeutic success. In addition to the epidemiological transition process occurring in Mexico, tuberculosis remains an important cause of CLA. Histopathology with confirmatory studies including PCR can detect tuberculous aetiology.
Asunto(s)
Países en Desarrollo , Enfermedades Linfáticas/epidemiología , Enfermedades Linfáticas/microbiología , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/epidemiología , Adolescente , Adulto , Anciano , ADN Bacteriano/análisis , Estudios Epidemiológicos , Femenino , Humanos , Incidencia , Enfermedades Linfáticas/etiología , Masculino , México/epidemiología , Persona de Mediana Edad , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/patogenicidad , Cuello/patología , Reacción en Cadena de la PolimerasaRESUMEN
The authors report one case of Parinaud's oculoglandular syndrome associated with Paracoccidioides brasiliensis infection. No other medical report of this condition was found in the medical literature available at Index Medicus and Medline. The eye involvement has been rather uncommon in paracoccidioidomycosis and this report emphasizes the possibility of this kind of presentation making it also necessary to include paracoccidioidomycosis among the several known causes of Parinaud's oculoglandular syndrome.
Asunto(s)
Conjuntivitis/microbiología , Trastornos de la Motilidad Ocular/microbiología , Paracoccidioidomicosis/complicaciones , Adulto , Conjuntivitis/patología , Humanos , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/patología , MasculinoRESUMEN
Bacillus Calmette Guerin (BCG) has been used to vaccinate against tuberculosis since 1921. Persistant skin and lymph node lesions yielding Mycobacterium bovis are a rare complication for which there is not standardized treatment. We report an 11 month old child with a progressive cutaneous nodule and lymphadenopathy after BCG vaccination. These rapidly cleared with administration of clarithromycin.
Asunto(s)
Vacuna BCG/efectos adversos , Claritromicina/uso terapéutico , Inmunocompetencia , Enfermedades Linfáticas/tratamiento farmacológico , Enfermedades de la Piel/tratamiento farmacológico , Administración Oral , Vacuna BCG/uso terapéutico , Claritromicina/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Lactante , Enfermedades Linfáticas/etiología , Enfermedades Linfáticas/microbiología , Mycobacterium bovis/inmunología , Mycobacterium bovis/aislamiento & purificación , Mycobacterium bovis/patogenicidad , Enfermedades de la Piel/etiología , Enfermedades de la Piel/microbiología , Tuberculosis/prevención & controlRESUMEN
We report the unusual simultaneous occurrence of lymphoepithelial cysts, cytomegalovirus (CMV) and mycobacterial infections in the intraparotid lymph nodes of a 52-year-old AIDS patient who died of disseminated mycobacteriosis. Although cytomegalovirosis is a common finding in the salivary glands of HIV patients, the association of CMV inclusions with lymphoepithelial cyst (LC) has not been previously reported. Parotid mycobacterial infection is an uncommon finding, despite its usual disseminated presentation in HIV patients. These data emphasize that in immunosuppressed patients, simultaneous diseases of the parotid gland may occur and should be considered for diagnosis and treatment.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Quistes/patología , Infecciones por Citomegalovirus/complicaciones , Enfermedades Linfáticas/complicaciones , Enfermedades de las Parótidas/complicaciones , Tuberculosis Ganglionar/complicaciones , Tuberculosis Bucal/complicaciones , Resultado Fatal , Humanos , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/virología , Masculino , Persona de Mediana Edad , Enfermedades de las Parótidas/microbiología , Enfermedades de las Parótidas/virologíaRESUMEN
Paracoccidioidomycosis, caused by the dimorphic fungus Paracoccidioides brasiliensis, is the most important systemic mycosis in Latin America. Imported cases have been reported in North America, Asia and Europe, in individuals who lived in endemic areas, sometimes many years before the development of clinical manifestations. The disease causes cutaneous and/or respiratory tract mucosal lesions as well as lymph node enlargement. Involvement of the oropharynx and/or the larynx, either alone or in association with pulmonary involvement, is one of the commonest clinical presentations. On MRI, the major features are mucosal lesions, usually hypointense on T1 weighted images and hyperintense on T2 weighted or fat suppressed images, affecting the oral cavity, oropharynx and larynx, with head and neck lymph node enlargement. Differential diagnosis includes other granulomatous infectious diseases, especially tuberculosis, and cancers such as squamous cell carcinoma and lymphomas.
Asunto(s)
Enfermedades de la Laringe/microbiología , Imagen por Resonancia Magnética , Enfermedades de la Boca/microbiología , Paracoccidioidomicosis/diagnóstico , Enfermedad Aguda , Adolescente , Adulto , Enfermedad Crónica , Diagnóstico Diferencial , Humanos , Enfermedades Linfáticas/microbiología , Masculino , OrofaringeRESUMEN
A 12-year-old girl had been presenting a woody infiltration and erythema in the frontal region and on the entire left half of the face, leading to deformity of the nose and buccal fissure, and adenomegaly in a posterior cervical chain, for the last 18 months. Sinusitis was diagnosed and treated with antibiotics, and submitted to ethmoid sinusotomy, with no improvement. Several laboratory tests were made to find the correct diagnosis. An intradermal test for delayed hypersensitivity showed a positive reaction (5 mm) with necrosis for metabolic antigens for Conidiobolus. An oral mucosa biopsy showed a dense lymphohistiocytic infiltrate and focal points of necrosis. Gomori staining for fungi revealed countless wide, nonseptate hyphae. Amphotericin B was prescribed during 35 days, with no improvement. Terbinafine given orally was started in association with amphotericin B. Reduction of the lesions was observed 2 months later. No side effects were seen during 4 months of treatment.
Asunto(s)
Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Dermatomicosis/tratamiento farmacológico , Entomophthora , Dermatosis Facial/microbiología , Naftalenos/uso terapéutico , Anfotericina B/administración & dosificación , Antifúngicos/administración & dosificación , Antígenos Fúngicos/análisis , Niño , Dermatomicosis/diagnóstico , Combinación de Medicamentos , Entomophthora/inmunología , Eritema/microbiología , Sinusitis del Etmoides/diagnóstico , Sinusitis del Etmoides/tratamiento farmacológico , Dermatosis Facial/diagnóstico , Dermatosis Facial/tratamiento farmacológico , Femenino , Humanos , Enfermedades Linfáticas/microbiología , Enfermedades de la Boca/microbiología , Naftalenos/administración & dosificación , Enfermedades Nasales/microbiología , TerbinafinaRESUMEN
We report a patient with primary lymphocutaneous Nocardia brasiliensis infection affecting the face and left arm. The mode of infection was via skin abrasions which occurred 2 weeks prior to the development of the skin lesions. Treatment with intravenous minocycline for 4 weeks resulted in a cure. We also review 12 previously reported Japanese cases of lymphocutaneous nocardiosis.