ArticleBMC infectious diseases2025
Solitary giant abscess extending from the left gluteal to thigh due to Nocardia cyriacigeorgica in an immunocompetent patient: a case report.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNocardia cyriacigeorgica, a rare aerobic actinomycete, primarily infects immunocompromised hosts but is increasingly reported in immunocompetent individuals. Pulmonary involvement is its predominant manifestation; solitary giant abscesses are exceptionally rare in all patients. CASE PRESENTATION: A 92-year-old immunocompetent woman with coronary artery disease presented with acute left gluteofemoral swelling, pain, and fever (39.5 °C) persisting for 10 days. Symptoms progressed despite empirical antibiotics. Magnetic resonance imaging (MRI) revealed a multiloculated abscess spanning the left gluteal, hip, and proximal thigh compartments. Routine pus cultures were negative. Metagenomic next-generation sequencing (mNGS) of drainage fluid identified Nocardia cyriacigeorgica at 48 h, guiding a targeted culture that confirmed the diagnosis within a further 72 h. Antimicrobial Susceptibility Testing demonstrated susceptibility to trimethoprim-sulfamethoxazole (TMP-SMX). Ultrasound-guided drainage and TMP-SMX therapy achieved complete clinical and radiological resolution within 6 weeks.
conclusionThis is the first reported case of an immunocompetent patient with a solitary giant Nocardia cyriacigeorgica abscess in the gluteofemoral region. mNGS facilitated rapid pathogen identification, guiding targeted culture and susceptibility testing. This approach establishes a diagnostic-therapeutic paradigm for early recognition and precision management of similar infections. CLINICAL TRIAL: Not applicable.
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