Primary cutaneous nocardiosis in an immune-competent patient

We present a patient who was hospitalized due to a purulent skin lesion wit h a surrounding erythematous area in the region of the right paranasal crea se accompanied by a swelling of the right eyelid. Initially the diagnosis o f a carbuncle caused by an infection with Staphylococcus aureus was suppose d. A surgical debridement was performed and an antibiotic therapy was start ed. Only special microbial investigations requested by the clinician led to the diagnosis of a cutaneous infection with Nocardia brasiliensis. The pre sented case is remarkable because the nocardia infection was in an immune-c ompetent patient and the patient showed a primary cutaneous nocardiosis wit hout dissemination.