Nocardial Mycetoma pedis: A Case Report Study

Document Type : Case Report


1 Assistant Professor of Endocrinology and Metabolism, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

2 Assistant Professor of Pathology, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

3 Associate Professor of Radiology and Interventional Radiology Fellowship, Medical Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

4 Medical Student, Department of Medicine, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran


Nocardiosis is an uncommon infection caused by Nocardia species, a group of aerobic actinomycetes. Nocardiosis may affect immunocompromised or immunocompetent patients and as this case was affected by a rare disorder, we describe it in this study. This paper describes a case of nocardial mycetoma from a hospital affiliated to Shiraz University of Medical Sciences. The case was a 52-year-old man with diabetes mellitus, who was admitted to our institution with a 5-year history of right lower extremity swelling with multiple discharging sinuses localized in distal part of the leg and dorsum of the foot following a penetrating injury to the affected foot. The wound culture yielded the growth of Nocardia species after incubation. Nocardiosis should be considered in the differential diagnosis of skin lesions, especially if patients have a history of trauma or contact with soil-contaminated materials. Our reported case increases knowledge about this rare, sporadic infection in our country.


  1. Filice GA. Nocardiosis. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th ed. USA: McGraw-Hill; 2018.
  2. Griffiths WA, Kohout E, Vessal K. Mycetoma in Iran. International Journal of Dermatology 1975; 14(3):209-13.
  3. Inamadar AC, Palit A. Primary cutaneous nocardiosis: a case study and review. Indian J Dermatol Venereol Leprol 2003; 69(6):386-91.
  4. Ambrosioni J, Lew D, Garbino J. Nocardiosis: updated clinical review and experience at a tertiary center. Infection 2010; 38(2):89-97.  
  5. Seol CA, Sung H, Kim DH, Ji M, Chong YP, Kim MN. The first korean case of disseminated mycetoma caused by nocardia pseudobrasiliensis in a patient on long-term corticosteroid therapy for the treatment of microscopic polyangiitis. Ann Lab Med 2013; 33(3):203-7.
  6. Sarris I, Berendt AR, Athanasous N, Ostlere SJ; OSIRIS collaborative study group. MRI of mycetoma of the foot: two cases demonstrating the dot-in-circle sign. Skeletal Radiol 2003; 32(3):179-83.