Nocardiosis diseminada: Reporte de un caso

Nocardiosis is a bacterial infection that has the potential to cause localized or systemic suppurated disease, with particular tropism for central nervous system and lung parenchyma. It appears as thin branched, gram-positive filaments that look similar to Actinomyces species (spp). Risk factors for acquiring nocardiosis are: glucocorticoid therapy, malignancies, immunosuppressive therapy, organ and hematopoietic stem cells transplantation, as well as HIV infection. There are no pathognomonic clinical signs, so the clinical manifestations can easily be confused with bacterial infections caused by Klebsiella spp., Pseudononas spp. and Mycobacterium spp., and fungal infections, parasites and malignant neoplasms. The diagnosis of nocardios is requires isolat ion and identification of the microbial organism, often requiring invasive procedures. Sulfonamides are considered the standard therapy, but other schemes have been proposed due to the high resistance rate. This paper reports on a case of a 65-year-old woman with a history of rheumatoid arthr i t i s t reated with monoclonal antibodies. The patient developed disseminated Nocardiosis. Herein we describe the initial management and diagnosis reached by histopathology.