Creator: Dr. Manish Purohit
Published: 2016-10-03T09:54:01-04:00

Patient's Query

Hello doctor,

A few weeks ago I went to the doctor with an open skin wound on my face. I was cultured as it looked like Staph infection and given antibiotics. I ended up putting raw, unfiltered honey on the wound and it cleared up in the next three days. There is only a small red scar now. The culture came back as positive for Nocardia. I have no fever, shortness of breath or any other symptoms to speak of. I have set an appointment with infectious disease specialist by next week. As the wound got healed, could it still be in my blood? Do I need to do anything before my visit? Should I push to be seen earlier?

Answer

Dr. Manish Purohit

Microbiology

Hi,

Welcome to icliniq.com.

I can understand your concern, but I require some more information.

What specimen you had given for culture and in how many days it came back positive?

What are the antibiotics you had taken earlier? How did you get that skin wound?

Revert back with the answers to the above questions to a microbiologist online --> https://www.icliniq.com/ask-a-doctor-online/microbiologist

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Patient's Query

Thank you doctor,

The result showed Nocardia brasiliensis and it just came today. It took longer than two weeks. I had the wound for three days, and I used only natural honey. It has been gone close to two weeks. I do not know the reason for the wound. It started as a pimple and grew into a wound that was like MRSA. It was smaller, probably less than a quarter inch.

Answer

Dr. Manish Purohit

Microbiology

Hi,

Welcome back to icliniq.com.

Thank you for the answers. But, you did not answer one thing. I mean Nocardia was found in which specimen weather it was blood culture or wound culture or any other specimen you have submitted to the laboratory.

First, I suggest you to not to be worried. As Nocardia is present in the environment it can cause infection of skin and it can be treated using appropriate antibiotics.

As you said you have used some natural substances locally and I would suggest do not use it. Or even if you wanted to use, then you should use it with oral medication.

Presently, no need to be worried as it is a local infection as your symptoms suggest.

I suggest you some investigation before starting treatment. Blood culture to rule out any systemic infection and complete blood count. Then, carry on with the scheduled appointment.

I am suggesting you some medication that you can take under the guidance of your local clinician. Trimethoprim with Sulfamethoxazole (Co-trimoxazole 960 mg) orally two times a day after meal. If allergic to sulfa drugs, then you can take Minocycline 100 mg two times a day orally for seven days.

If there is any pain, redness or burning locally, then take NSAIDS (nonsteroidal anti-inflammatory drugs) orally for five days. Maintain local cleaning and apply any antibacterial ointment.

Take Pantoprazole 40 mg once a day on an empty stomach to prevent drug induced gastritis. Repeat the culture of the wound after five days of treatment.

Revert back after seven days to a microbiologist online --> https://www.icliniq.com/ask-a-doctor-online/microbiologist

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