Managing nocardiosis: a review and case series of its treatment with trimethoprim–sulfamethoxazole

Nocardiosis is clinically challenging because of its variable clinicopathologic features, the inherent difficulties in cultivating the pathogen, the lack of exact treatment regimen, and its high propensity to recur. We report a case series of nocardiosis with diverse clinical presentations (primary pulmonary, primary cutaneous, and disseminated) and successful treatment with trimethoprim–sulfamethoxazole (TMP–SMX). We briefly review the cases to assess the efficacy of treatment with TMP–SMX. The optimal therapy for nocardiosis has yet to be established. Our clinical experience, together with the clinical evidence in the literature, suggests that TMP–SMX should be considered as the therapeutic drug of choice for treating nocardiosis.