Lymphocutaneous Nocardiosis in a Patient With Human Immunodeficiency/Tuberculosis Coinfection

Nocardia spp. are Gram-positive bacteria, which are acid-fast as well. Nocardiosis is characterized by abscess formation anywhere in the body, especially in the lungs, brain, and skin. The disease manifests as pulmonary disease, brain abscess, or disseminated lesions in immunocompromised individuals. However, skin involvement in the form of lymphocutaneous abscess is found in immunocompetent individuals. Nocardia spp. appear as thin, branched filaments in fine needle aspirate under the microscope. Diagnosis of the nocardiosis is done by fine needle aspiration cytology (FNAC) and identification through matrix-assisted laser desorption/ionization-time of flight mass spectrometry from aspirated materials. Our case is lymphocutaneous nocardiosis in a patient having human immunodeficiency (HIV)/tuberculosis coinfection.