Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
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Background: Nocardia brasiliensis, an uncommon human pathogen, is rarely seen in infections secondary to insect bites or stings. However, Nocardia brasiliensis can infect an individual through an ulcerative wound, such as one mediated by the phospholipase D toxin immune response following a Loxosceles reclusa (i.e., brown recluse spider) bite.
Case Report: This report presents the case of a patient who underwent a spinal cord stimulator (SCS) trial with an unknown brown recluse spider bite on her left foot. We describe the Nocardia brasiliensis cutaneous infection following a brown recluse bite and the effective management of the infection through long-term antibiotic use, which allowed for the eventual successful implantation of the SCS.
Conclusion: The present case urges health care providers to conduct thorough, full-body examinations prior to any surgical procedure to identify and treat all remote infections prior to SCS implantations, as advised by the Neurostimulation Appropriateness Consensus Committee’s recommendations for infection prevention.
Key words: Nocardiosis, Loxosceles reclusa, Nocardia brasiliensis, spinal cord stimulation, case report
