Successful treatment with amoxicillin-clavulanic acid: cutaneous nocardiosis caused by Nocardia brasiliensis

Abstract

Aim

To emphasize the role of non-sulfonamides in the treatment of Nocardia infection and reduce the adverse reactions caused by sulfonamides.

Methods

We retrospectively analyzed a case of cutaneous nocardiosis in an immunocompetent individual. The colonies obtained by staining the pus in the lesion with antacid and culturing the agar plates were identified by flight mass spectrometry. The pathogenic identification showed Nocardia brasiliensis infection and the patient was treated with amoxicillin-clavulanic acid.

Results

After treatment with amoxicillin and clavulanic acid, the ulcer gradually peeled and crusted, leaving dark pigmentation. The patient has finally recovered.

Conclusion:

Sulfonamides are the first-line antibacterial agents for years in treatment of nocardiosis but are of great toxicity and side effects. This patient was successfully treated with amoxicillin-clavulanic acid and it provided a reference protocol for patients with sulfonamide-resistant Nocardia or sulfonamides intolerance.

Keywords:

• Sulfonamides
• toxic side effects
• Nocardia brasiliensis
• amoxicillin-clavulanic acid
• nocardiosis

Acknowledgements

We thank all members of the microbiology laboratory of Zhejiang Provincial People’s Hospital for their help in the collection of clinical data.

Ethics approval and consent to participate

This study was supported by the Ethics Committee of Zhejiang People’s Hospital (Ethics Committee Approval of Biomedical Research Involving Humans, Approval No.: 2022JS008) and was carried out in accordance with the ethical standards of the Declaration of Helsinki.

Consent for publication

Written and informed consent was obtained from the patient for publication of this case report and any accompanying images.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data available on request from the corresponding author.

Table 1. Antimicrobial susceptibility of the Nocardia brasiliensis by Kirby–Bauer method and Epsilometer test.

Additional information

Funding

This study was supported by the [New Project of Zhejiang Provincial People’s Hospital entitled ‘Construction of Rapid Nucleic Acid Detection Platform for Invasive Fungi’] under Grant [number 20211214].