Touch preparation of skin biopsy specimen for rapid diagnosis of cutaneous Nocardia nova in the immunocompromised host  Edward C. Traver, MD, Sameera.

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Touch preparation of skin biopsy specimen for rapid diagnosis of cutaneous Nocardia nova in the immunocompromised host  Edward C. Traver, MD, Sameera Husain, MD, Marc E. Grossman, MD  JAAD Case Reports  Volume 5, Issue 4, Pages 389-391 (April 2019) DOI: 10.1016/j.jdcr.2019.02.010 Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Red-brown papulonodules were present on the anterior surface of the right lower leg of a transplant patient for 2 days and diagnosed as cutaneous Nocardia nova. Inset, Wider view of the same leg. JAAD Case Reports 2019 5, 389-391DOI: (10.1016/j.jdcr.2019.02.010) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Touch preparation of a punch biopsy specimen of right lower leg papulonodules, prepared with modified acid-fast stain, revealed abundant acid-fast branching filaments in a background of neutrophils consistent with Nocardia. (Original magnification: ×40.) JAAD Case Reports 2019 5, 389-391DOI: (10.1016/j.jdcr.2019.02.010) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Gomori methenamine silver staining of a biopsy specimen obtained from right lower leg nodules revealed branching filamentous organisms consistent with Nocardia. (Original magnification: ×100.) JAAD Case Reports 2019 5, 389-391DOI: (10.1016/j.jdcr.2019.02.010) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Fungal culture of the skin biopsy specimen revealed white cotton ball–like colonies on chocolate agar after 2 weeks of incubation, identified as Nocardia nova. JAAD Case Reports 2019 5, 389-391DOI: (10.1016/j.jdcr.2019.02.010) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions