Manifestations and Management of Trimethoprim/Sulfamethoxazole-Resistant Nocardia otitidiscaviarum Infection

Emerg Infect Dis. 2023 Jun;29(6):1266-1267. doi: 10.3201/eid2906.221854.


Nocardia can cause systemic infections with varying manifestations. Resistance patterns vary by species. We describe N. otitidiscavarium infection with pulmonary and cutaneous manifestations in a man in the United States. He received multidrug treatment that included trimethoprim/sulfamethoxazole but died. Our case highlights the need to treat with combination therapy until drug susceptibilities are known.

Keywords: Nocardia; Nocardia otitidiscaviarum; United States; antimicrobial resistance; bacteria; chronic obstructive pulmonary disease; cutaneous abscess; drug resistance; trimethoprim/sulfamethoxazole.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Male
  • Nocardia Infections* / diagnosis
  • Nocardia Infections* / drug therapy
  • Nocardia*
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use


  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Anti-Bacterial Agents

Supplementary concepts

  • Nocardia otitidiscaviarum