# Disseminated Nocardia paucivorans infection in a 64-year-old patient with first manifestation as an ulnocarpal forearm lesion

## TL;DR

A 64-year-old cancer patient developed a rare Nocardia infection starting as a forearm lesion and spreading to the lungs and brain.

## Contribution

This case highlights Nocardia paucivorans as a disseminated infection in immunocompromised patients with cancer.

## Key findings

- Nocardia paucivorans was identified in a forearm lesion of an immunocompromised patient.
- PET-CT and MRI showed pulmonary and cerebral involvement of the infection.
- Antimicrobial therapy reduced brain lesions, but the patient died from the underlying cancer.

## Abstract

We report a 64-year-old immunocompromised patient receiving chemotherapy for metastatic colorectal adenocarcinoma who presented with a purulent forearm lesion. Surgical debridement identified Nocardia paucivorans. PET-CT and MRI revealed pulmonary and cerebral involvement. Escalated antimicrobial therapy achieved complete regression of brain lesions; the patient died 11 months later from underlying disease.