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My culture report showed Nocardia positive. How to proceed?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At October 3, 2016
Reviewed AtJune 11, 2023

Patient's Query

Hello doctor,

A few weeks ago I went to the doctor with an open skin wound on my face. It was cultured as it looked like a 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 an infectious disease specialist for 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?

Answered by Dr. Purohit Manish


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?

Patient's Query

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 for 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.

Answered by Dr. Purohit Manish


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 whether it was blood culture or wound culture or any other specimen you have submitted to the laboratory.

First, I suggest you not be worried. As Nocardia is present in the environment it can cause infection of the 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 them. Or even if you wanted to use it, 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 do 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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Purohit Manish
Dr. Purohit Manish


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