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Rheumatology 2001; 40: 949-952
© 2001 British Society for Rheumatology

Letters to the Editor

Disseminated nocardiosis presenting as a flare of Behçet's disease

C. Auzary,1,2, L. T. H. Du Boutin2, B. Wechsler2, P. Chollet3 and J. C. Piette2

1 Service de Médecine interne, Centre Hospitalier de Moulins-Yzeure, 10 avenue du général de Gaulle, BP 609, 03006 Moulins cedex,
2 Service de Médecine interne, Hôpital de la Pitié-Salpêtrière, 47–83 boulevard de l'Hôpital, 75651 Paris cedex 13 and
3 Service de Médecine interne, Centre Hospitalier Inter Communal de Tarbes-Vic en Bigorre, Boulevard de Lattre de Tassigny, BP 1330, 65013 Tarbes cedex 9, France

SIR, Behçet's disease (BD) is an inflammatory disorder characterized by the classic triad of recurrent oral and genital aphthae and uveitis, and by possible multisystem involvement (e.g. central nervous system, pulmonary system, digestive tract) and an increased tendency to thrombosis. Its relapsing course often requires immunosuppressive therapy.

Nocardiosis is mainly an opportunistic infection due to aerobic actinomycetes and is characterized by a primary respiratory focus and potential haematogenic dissemination, mainly to the brain and skin. We report the occurrence of disseminated nocardiosis due to Nocardia asteroides in an immunosuppressed patient who presented with a neurological deficit, visual deterioration and cutaneous nodular lesions mimicking a flare of BD despite immunosuppressive therapy.

A 45-yr-old man, born in Portugal, was referred to the hospital in October 1998 with a suspected BD flare. He had suffered recurrent oral aphthosis and painful genital ulcerations since the age of 10 yr. A sural thrombophlebitis . . . [Full Text of this Article]

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