Nocardia asteroides infections in humans characteristically produce which of the following clinical features?

• A. Septic shock
• B. Draining cutaneous sinuses
• C. Carbuncles
• D. Serous effusions

Answer: (B)

Nocardia infections tend to cause chronic granulomatous lesions that develop into draining sinus tracts, especially in cutaneous disease. This draining of purulent material through sinus openings is a hallmark of cutaneous nocardiosis and reflects the slow, indolent inflammatory response Nocardia elicits. The organism often presents after skin trauma or via inhalation with a course that evolves over time rather than causing an abrupt, life-threatening systemic reaction. Septic shock represents a rapid, systemic collapse not typical of nocardia’s usual presentation; carbuncles are more characteristic of Staphylococcus aureus infections; serous effusions are not a defining feature of nocardial disease. Therefore, draining cutaneous sinuses best describe the clinical feature associated with Nocardia asteroides infections.