Abstract: A 52-year-old female patient presented with redness, swelling, papules and nodules on the left dorsum pedis and ankle for half a year, which responded poorly to multiple antibiotics. She was engaged in greenhouse vegetable cultivation with a history of repeated foot trauma. Histopathology showed pyogenic granulomatous inflammation. Bacterial colonies were observed by hexamine silver staining. Metagenomic next-generation sequencing (mNGS) confirmed the diagnosis of Nocardia brasiliensis infection. The patient was treated with compound sulfamethoxazole 0.96 g twice daily, and the skin lesions improved significantly after 1 month. A review of 12 reported cases of Nocardia brasiliensis infection in the literature revealed that 7 cases had a history of soil/plant contact, suggesting that agricultural workers may be a high-risk group for Nocardia brasiliensis infection.

Key words: cutaneous nocardiosis, Nocardia brasiliensis, metagenomic next-generation sequencing (mNGS)