{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:39:19Z","timestamp":1754163559509,"version":"3.41.2"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Actinomycetoma is a chronic, progressive bacterial infection characterized by granuloma formation, with Nocardia vulneris being a rare causative agent. A 32-year-old healthy man from El Salvador presented with painless nodules, scars and discharging sinus tracts on his back. Examination of the exudate revealed small white grains, and Nocardia species were isolated through culture. Molecular identification of N.\u00a0vulneris was confirmed via 16S rDNA gene amplification and sequencing. The patient was treated with trimethoprim\u2013sulfamethoxazole and dapsone, resulting in significant clinical improvement after 6 months. He continues on this treatment regimen. This case highlights the rarity of N. vulneris mycetoma at an unusual anatomical site and demonstrates the effectiveness of combined trimethoprim\u2013sulfamethoxazole and dapsone therapy.<\/jats:p>","DOI":"10.1093\/skinhd\/vzaf041","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T10:19:45Z","timestamp":1750846785000},"page":"297-302","source":"Crossref","is-referenced-by-count":0,"title":["<i>Nocardia vulneris<\/i>: a rare pathogen in actinomycetoma \u2013 a case report and review of the literature"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1654-9706","authenticated-orcid":false,"given":"Teerapong","family":"Rattananukrom","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-9564","authenticated-orcid":false,"given":"Roberto","family":"Arenas","sequence":"additional","affiliation":[{"name":"Mycology Section, \u2018Dr Manuel Gea Gonzalez\u2019 General Hospital , Mexico City ,","place":["Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5870-8055","authenticated-orcid":false,"given":"Yosbeli","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Residente del Primer a\u00f1o de Dermatolog\u00eda, Universidad Evang\u00e9lica de El Salvador , San Salvador ,","place":["El Salvador"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5073-6620","authenticated-orcid":false,"given":"Ana","family":"Luz Ely Guevara-Cerritos","sequence":"additional","affiliation":[{"name":"Dermat\u00f3loga Adscrita at Hospital Nacional \u2018Dr Juan Jos\u00e9 Fern\u00e1ndez Zacamil\u2019, Centro Dermatol\u00f3gico, San Salvador , Mejicanos ,","place":["El Salvador"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-0942","authenticated-orcid":false,"given":"Rigoberto","family":"Hernandez-Castro","sequence":"additional","affiliation":[{"name":"Departamento de Ecolog\u00eda de Agentes Pat\u00f3genos, \u2018Dr Manuel Gea Gonzalez\u2019 General Hospital , Mexico City ,","place":["Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"2025073101314495900_vzaf041-B1","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.jdcr.2019.06.003","article-title":"Twenty-year cervicothoracic Nocardia mycetoma with advanced thoracic cavity infiltration","volume":"5","author":"Eaton","year":"2019","journal-title":"JAAD Case Rep"},{"key":"2025073101314495900_vzaf041-B2","doi-asserted-by":"crossref","first-page":"e0008397","DOI":"10.1371\/journal.pntd.0008397","article-title":"The global distribution of actinomycetoma and eumycetoma","volume":"14","author":"Emery","year":"2020","journal-title":"PLOS Negl Trop Dis"},{"key":"2025073101314495900_vzaf041-B3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ced.13642","article-title":"Mycetoma: reviewing a neglected disease","volume":"44","author":"Verma","year":"2019","journal-title":"Clin Exp Dermatol"},{"key":"2025073101314495900_vzaf041-B4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/0970-9371.73297","article-title":"Eumycetoma versus actinomycetoma: diagnosis on cytology","volume":"27","author":"Afroz","year":"2010","journal-title":"J Cytol"},{"key":"2025073101314495900_vzaf041-B5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1093\/trstmh\/trad057","article-title":"Evaluation of a computational model for mycetoma-causative agents identification","volume":"118","author":"Omar Ali","year":"2024","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2025073101314495900_vzaf041-B6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/trstmh\/traa176","article-title":"Actinomycetoma laboratory-based diagnosis: a mini-review","volume":"115","author":"Siddig","year":"2021","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2025073101314495900_vzaf041-B7","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1111\/jdv.13008","article-title":"Eumycetoma and actinomycetoma \u2013 an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy","volume":"29","author":"Nenoff","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025073101314495900_vzaf041-B8","doi-asserted-by":"crossref","first-page":"e3102","DOI":"10.1371\/journal.pntd.0003102","article-title":"Mycetoma: experience of 482 cases in a single center in Mexico","volume":"8","author":"Bonifaz","year":"2014","journal-title":"PLOS Negl Trop Dis"},{"key":"2025073101314495900_vzaf041-B9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S1473-3099(15)00359-X","article-title":"Mycetoma: a unique neglected tropical disease","volume":"16","author":"Zijlstra","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"2025073101314495900_vzaf041-B10","first-page":"586","article-title":"Update on the epidemiology of mycetoma in Mexico. A review of 3933 cases","volume":"149","author":"L\u00f3pez-Mart\u00ednez","year":"2013","journal-title":"Gac Med Mex"},{"key":"2025073101314495900_vzaf041-B11","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1111\/1346-8138.17206","article-title":"Intractable nocardial mycetoma with possible colonisation by Candida species","volume":"51","author":"Sumioki","year":"2024","journal-title":"J Dermatol"},{"key":"2025073101314495900_vzaf041-B12","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/trstmh\/traa199","article-title":"Mycetoma and the community dermatology program, Mexico","volume":"115","author":"Roberto","year":"2021","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2025073101314495900_vzaf041-B13","doi-asserted-by":"crossref","first-page":"e04673","DOI":"10.1002\/ccr3.4673","article-title":"Disseminated Nocardia infection-a rare presentation","volume":"9","author":"Arora","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025073101314495900_vzaf041-B14","doi-asserted-by":"crossref","first-page":"270","DOI":"10.4103\/idoj.idoj_133_23","article-title":"Sporotrichoid primary cutaneous nocardiosis: a rare case of isolated upper-limb \u00adinvolvement in a housewife","volume":"15","author":"Sultan","year":"2024","journal-title":"Indian Dermatol Online J"},{"key":"2025073101314495900_vzaf041-B15","doi-asserted-by":"crossref","first-page":"e0002721","DOI":"10.1128\/cmr.00027-21","article-title":"Updated review on Nocardia species: 2006-2021","volume":"35","author":"Traxler","year":"2022","journal-title":"Clin Microbiol Rev"},{"key":"2025073101314495900_vzaf041-B16","first-page":"e57753","article-title":"Actinomycetoma by Nocardia asteroides: a case report of a unique neglected tropical disease from north India","volume":"16","author":"Singh","year":"2024","journal-title":"Cureus"},{"key":"2025073101314495900_vzaf041-B17","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/tmi.13828","article-title":"Diagnostics to support mycetoma management-development of two target product profiles","volume":"27","author":"Fongwen","year":"2022","journal-title":"Trop Med Int Health"},{"key":"2025073101314495900_vzaf041-B18","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1517\/14656566.9.12.2077","article-title":"Emerging therapeutic regimes for the management of mycetomas","volume":"9","author":"Ameen","year":"2008","journal-title":"Expert Opin Pharmacother"},{"key":"2025073101314495900_vzaf041-B19","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.clindermatol.2011.06.027","article-title":"Actinomycetoma and advances in its treatment","volume":"30","author":"Welsh","year":"2012","journal-title":"Clin Dermatol"},{"key":"2025073101314495900_vzaf041-B20","doi-asserted-by":"crossref","first-page":"866420","DOI":"10.3389\/fpubh.2022.866420","article-title":"Case report: disseminated nocardiosis caused by Nocardia vulneris in a patient with macroglobulinemia","volume":"10","author":"Qiu","year":"2022","journal-title":"Front Public Health"},{"key":"2025073101314495900_vzaf041-B21","doi-asserted-by":"crossref","first-page":"e0011432","DOI":"10.1371\/journal.pntd.0011432","article-title":"The species distribution and antimicrobial resistance profiles of Nocardia species in China: a systematic review and meta-analysis","volume":"17","author":"Wang","year":"2023","journal-title":"PLOS Negl Trop Dis"},{"key":"2025073101314495900_vzaf041-B22","doi-asserted-by":"crossref","first-page":"ofad409","DOI":"10.1093\/ofid\/ofad409","article-title":"Mortality after nocardiosis: risk factors and evaluation of disseminated infection","volume":"10","author":"Yetmar","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2025073101314495900_vzaf041-B23","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1093\/cid\/ciab866","article-title":"Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation","volume":"75","author":"Averbuch","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2025073101314495900_vzaf041-B24","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1093\/jac\/dkad236","article-title":"Phenotypic and genotypic analysis of antimicrobial resistance in Nocardia species","volume":"78","author":"Hershko","year":"2023","journal-title":"J Antimicrob Chemother"},{"key":"2025073101314495900_vzaf041-B25","first-page":"754","article-title":"Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain","volume":"72","author":"Valdezate","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2025073101314495900_vzaf041-B26","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001581","article-title":"Identification and antimicrobial susceptibility of referred Nocardia isolates in Victoria, Australia 2009\u20132019","volume":"71","author":"Yeoh","year":"2022","journal-title":"J Med Microbiol"},{"key":"2025073101314495900_vzaf041-B27","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1093\/trstmh\/trab072","article-title":"Global scientific research progress in mycetoma: a bibliometric analysis","volume":"115","author":"Musa","year":"2021","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2025073101314495900_vzaf041-B28","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/trstmh\/trac069","article-title":"Mycetoma management and clinical outcomes: the mycetoma research center experience","volume":"117","author":"Musa","year":"2023","journal-title":"Trans R Soc Trop Med Hyg"}],"container-title":["Skin Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/5\/4\/297\/63579754\/vzaf041.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/5\/4\/297\/63579754\/vzaf041.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:31:57Z","timestamp":1753939917000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/skinhd\/article\/5\/4\/297\/8173692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":28,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,6,25]]},"published-print":{"date-parts":[[2025,7,31]]}},"URL":"https:\/\/doi.org\/10.1093\/skinhd\/vzaf041","relation":{},"ISSN":["2690-442X"],"issn-type":[{"type":"electronic","value":"2690-442X"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,6,25]]}}}