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Nocardia Infections of the Face and Neck

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Abstract

Involvement of the soft tissues of the face and neck by Nocardia spp. is uncommon. We review the epidemiology, clinical features, diagnosis, and management of such infections in the setting of primary cutaneous nocardiosis and disseminated disease. Although immune compromise is an important risk factor for these infections, they also occur in healthy individuals. Infection may arise through direct inoculation following injury or by hematogenous spread from a primary site, usually the lung. The rare variant of lymphocutaneous disease—cervicofacial nocardiosis—typically affects children, but can occur in adults. The diagnosis is made by conventional microscopy and culture, but radiological imaging is useful to delineate disease extent, and molecular methods are increasingly assisting the diagnosis by providing rapid detection and identification of the pathogen. Sulfonamides remain the preferred treatment for many cases and are an important component of the therapeutic armamentarium. Other therapeutic options include minocycline, the carbapenems, and linezolid.

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Acknowledgments

The work of T.C. Sorrell and S.C-A. Chen was funded in part by a Centre of Clinical Research Excellence grant from the National Health and Medical Research Council of Australia (number 264625) and a Fellowship to T.C. Sorrell from the Sydney Medical School Foundation.

Disclosure

Conflicts of interest: A.C. Outhred—none; M.R. Watts—none; S.C-A. Chen—none; T.C. Sorrell—none.

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Authors and Affiliations

  1. Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead, NSW, Australia

    Alexander C. Outhred, Matthew R. Watts, Sharon C-A. Chen & Tania C. Sorrell

  2. Sydney Institute for Emerging Infections and Biosecurity, University of Sydney, Westmead, NSW, Australia

    Sharon C-A. Chen & Tania C. Sorrell

  3. Westmead Millennium Institute, University of Sydney, Westmead, NSW, Australia

    Tania C. Sorrell

  4. Centre for Infectious Diseases and Microbiology, Westmead Hospital, Darcy Road, Westmead, NSW, 2145, Australia

    Tania C. Sorrell

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  1. Alexander C. Outhred
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Correspondence to Tania C. Sorrell.

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Outhred, A.C., Watts, M.R., Chen, S.CA. et al. Nocardia Infections of the Face and Neck. Curr Infect Dis Rep 13, 132–140 (2011). https://doi.org/10.1007/s11908-011-0165-0

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