Primary cutaneous nocardiosis caused by nocardia brasiliensis

Nocardiosis is an uncommon, potentially life-threatening infectious disease caused by several species of the genus Nocardia, which are Gram-positive branched bacilli. Most infections enter through the respiratory tract and then disseminate systemically but rarely has a primary infection occurred resulting from direct inoculation. Isolation of Nocardia from clinical specimens and identification of species is difficult and require a specialized microbiologist. We report a case of primary cutaneous nocardiosis caused by N. brasiliensis in a 68-year-old man who was diagnosed by bacterial culture and 16S ribosomal RNA sequencing. The skin lesions improved with trimethoprimsulfamethoxazole antibiotic therapy for 6 months.