A Thorny Problem

A 75-year-old woman develops painful, spreading lesions on her hand and arm after a minor injury. What common activity could lead to this Skin Infection?

Gardening


A 75-year-old woman presented to the infectious diseases clinic with a 10-day history of painful lesions on the right hand and forearm. An aspiration of the hand lesion was performed. Bacterial culture of the aspirate grew filamentous, gram-positive, acid-fast branching rods. Which of the following activities likely preceded development of the lesions?

What is the most likely diagnosis?

Cleaning a fish tank
Gardening
Getting bitten by a sandfly
Handling feline waste
Petting an armadillo

Gardening, Lymphangitis, Nocardia, Nocardiosis, Sporotrichoid

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