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Q. My culture report showed Nocardia positive. How to proceed?

Answered by
Dr. Manish Purohit
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 03, 2016 and last reviewed on: Sep 15, 2020

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?

#

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

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.

#

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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