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Nocardia abscessus-Associated Subcutaneous Infection in a Patient with Non-Hodgkin’s Lymphoma

Ahmet Karakaş, Abdullah Kılıç, Cumhur Artuk, Mutahher Akçaer, Duran Tok, Yüksel Yurttaş, Ömer Coşkun, Bülent Beşirbellioğlu.

This paper describes primary subcutaneous infection caused by N. abscessus in a 60-year-old male patient with the history of non-Hodgkin’s lymphoma and chronic lymphocytic leukemia. The patient was presented with pain and swelling in his left thigh for 45 days. Soft tissue ultrasonography showed a heterogeneous and hypoechoic mass consistent with an abscess. Gram-positive and branched filamentous bacilli, along with neutrophils, were identified in gram-stained smears of the pus. Pus culture was positive for Gram-positive bacilli, which identified as N. abscessus. Initially, the patient was treated with trimethoprim-sulfamethoxazole. Due to insufficient clinical response, ceftriaxone was added for two weeks. Then, the patient was prescribed a 3-month course of trimethoprim-sulfamethoxazole. It is important to start appropriate and effective treatment as soon as possible in patients with immunosuppression.

Key words: Nocardiosis; primary cutaneous nocardiosis; Nocardia abscessus; lymphoma; immunosuppression

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