{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:59:20Z","timestamp":1785509960270,"version":"3.56.0"},"reference-count":21,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,4]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Nocardiosis is known to be an opportunistic infection most commonly affecting immunocompromised patients that can lead to life-threatening conditions. Primary cutaneous disease remains a rare manifestation and unlike pulmonary or disseminated nocardiosis, it usually affects immunocompetent individuals. We present a case of a primary cutaneous nocardiosis of the head and neck after an insect bite in a healthy 50-year-old woman who had recently travelled from Greece. She presented with a painful right-sided swelling of her face and neck and an ulcerated plaque over the right temple. Biopsy of the plaque revealed inflammation with abscess formation indicating underlying infection. Culture from the biopsy showed growth of <jats:italic>Nocardia<\/jats:italic> spp and 16S rRNA gene sequence analysis identified <jats:italic>Nocardia brasiliensis<\/jats:italic>. The patient was treated with trimethoprim\/sulfamethoxazole and subsequently switched to amoxicillin\/clavulanic acid due to a drug eruption. Antibiotic therapy was continued for a total of 3 months with complete resolution of the skin lesions.<\/jats:p>","DOI":"10.1136\/bcr-2020-241217","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T12:31:38Z","timestamp":1621945898000},"page":"e241217","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Primary cutaneous nocardiosis of the head and neck in an immunocompetent patient"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3624-9401","authenticated-orcid":false,"given":"Claudio Tirso","family":"Acevedo","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Imkamp","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewerton","family":"Marques Maggio","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9492-9088","authenticated-orcid":false,"given":"Silvio Daniel","family":"Brugger","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"2025082712031320000_14.5.e241217.1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.19.2.259-282.2006"},{"key":"2025082712031320000_14.5.e241217.2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181afa1c8"},{"key":"2025082712031320000_14.5.e241217.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2011.11.016"},{"key":"2025082712031320000_14.5.e241217.4","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-009-9193-9"},{"key":"2025082712031320000_14.5.e241217.5","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1055\/s-0040-1708816","article-title":"Nocardia spp: a rare cause of pneumonia globally","volume":"41","author":"Lynch","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"2025082712031320000_14.5.e241217.6","doi-asserted-by":"crossref","DOI":"10.1007\/s11908-019-0684-7","article-title":"Updates on Nocardia skin and soft tissue infections in solid organ transplantation","volume":"21","author":"Hemmersbach-Miller","year":"2019","journal-title":"Curr Infect Dis Rep"},{"key":"2025082712031320000_14.5.e241217.7","unstructured":"European Centre for Disease Prevention and Control (ECDC) . 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