Chronic renal insufficiency complicated by skin infection with Nocardia brasiliensis:A case report  

作　　者：Shan-Shan Zhang Ying Lu Wen-Ning Fu 

机构地区：[1]College of Integrated Traditional Chinese and Western Medicine Clinical Medicine,Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University,Hangzhou 310012,Zhejiang Province,China [2]Department of Nephrology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang Province,China [3]Department of Nephrology and Rheumatology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2025年第20期78-84,共7页世界临床病例杂志(英文)

基　　金：Supported by Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program,No.2023ZF075.

摘　　要：BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.

关 键 词：Cutaneous nocardiosis Nocardia brasiliensis Chronic renal insufficiency Skin infection Immunocompromised patients Case report 

分 类 号：R519[医药卫生—内科学]