Dermatologic Manifestations of Nocardiosis Treatment & Management

  • Author: Brent A Shook, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 11, 2012
 

Medical Care

Most patients with primary cutaneous nocardiosis require antibiotic therapy to resolve the infection. Recommendations regarding the duration of therapy range from 2-3 months for most cutaneous infections to 1 year for chronic cutaneous and systemic infections. Trimethoprim-sulfamethoxazole (TMP-SMZ) is used most frequently for nocardiosis.

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Surgical Care

Surgical debridement or excision often is vital in the treatment of nocardiosis. Surgery is most helpful in abscesses and mycetomas, but it can also help resolve lymphocutaneous infection. In a review of nocardial lymphocutaneous syndrome published in 1999,[16] of 50 patients, 11 required surgery as a primary or secondary treatment.

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Consultations

  • Consult a dermatologist regarding the diagnostic workup and optimization of therapy.
  • Consult an infectious disease specialist regarding the diagnostic workup and optimization of therapy.
  • Consultation with a general surgeon or orthopedic surgeon may be required if extensive surgical debridement is necessary.
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Activity

Activity depends on the severity of illness and the location of the infection.

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Contributor Information and Disclosures
Author

Brent A Shook, MD  Director, The Woodlands Skin Surgery Center, The Woodlands, Texas

Brent A Shook, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Society for MOHS Surgery, Christian Medical & Dental Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD  Josey Professor and Chair, Department of Dermatology, Professor of Pathology, University of Texas Medical School at Houston and MD Anderson Cancer Center

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Society for Investigative Dermatology, and Texas Medical Association

Disclosure: Elsevier publishers Royalty Independent contractor

Specialty Editor Board

Daniel Mark Siegel, MD, MS  Director, Procedural Dermatology Fellowship Program, Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physician Executives, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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Red nodules on a patient with disseminated nocardiosis.
Ulcer on the arm of a patient with primary cutaneous nocardiosis.
Gomori methenamine silver stain demonstrating black filamentous Nocardia species.
 
 
 
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