PRIMARY SOFT-TISSUE NOCARDIOSIS

A 20-year-old Latin American man presented with a 41/2-year history of a left infrapatellar mass with multiple draining sinuses. Multiple co urses of oral antibiotics before referral were unsuccessful in eradica ting the mass. Microscopic examination of material obtained by punch, core needle, and incisional biopsies demonstrated nonspecific acute an d chronic inflammation. Surgical resection demonstrated an inflammator y mass with multiple abscess cavities. Intraoperative cultures grew No cardia asteroides. The infection was successfully treated with a prolo nged course of a trimethoprim-sulfamethoxazole.