Primary Cutaneous Nocardiosis Due to Nocardia Farcinica: A Case Report of an Often Overlooked Infection

Exploring Nocardia's ecological spectrum and novel therapeutic frontiers through whole-genome sequencing: unraveling drug resistance and virulence factors

Nocardia farcinica is the leading pathogen responsible for nocardiosis, a life-threatening infection primarily affecting immunocompromised patients. In this study, the genomic sequence of a clinically isolated N. farcinica sample was sequenced. Subsequently, the assembled genome was annotated to identify antimicrobial resistance and virulence genes, as well as plasmid and prophages. The analysis of the entire genome size was 6,021,225 bp, with a GC content of 70.78% and consists of 103 contigs and N50 values of 292,531 bp. The genome analysis revealed the presence of several antimicrobial resistance genes, including RbpA, mtrA, FAR-1, blaFAR-1, blaFAR-1_1, and rox. In addition, virulence genes such as relA, icl, and mbtH were also detected. The present study signifies that N. farcinica genome is pivotal for the understanding of antimicrobial resistance and virulence genes is crucial for comprehending resistance mechanism, and developing effective strategies to combat bacterial infections effectively, especially adhesins and toxins. This study aids in identifying crucial drug targets for combating multidrug-resistant N. farcinica in the future.

Disseminated Nocardiosis with Pulmonary Fungus and Secondary Epilepsy: A Case Report

Disseminated nocardiosis is a rare, life-threatening disease that usually found in immunocompromised patients, and Nocardia farcinica is one of the most common causative pathogens. The difficulty in identifying the bacterium and the delay in initiating appropriate therapy often influence the prognosis of patients with disseminated nocardiosis. Here, we present a rare case of disseminated nocardiosis in a 61-year-old female with pulmonary fungus and secondary epilepsy. She received targeted antibiotic therapy and showed a great recovery in clinical symptoms and radiological signs. Disseminated nocardiosis can be easily overlooked due to the absence of characteristic symptoms and limitations of clinical examinations. Given the variability in antibiotic susceptibility patterns, the management of disseminated nocardiosis must be individualized. Therefore, early diagnosis and targeted antibiotic treatment are critical for the prognosis of disseminated nocardiosis.