Actinomycetoma Following Traumatic Inoculation of Nocardia Brasiliensis

A 32-year-old male without significant past medical history presented with acute-onchronic, mildly tender, enlarging, draining nodules and sinus tracts on the right lower extremity. The lesions had been present for 2 years following a penetrating injury at a construction site in central Mexico. He sought local hospital attention after the injury and was treated with penicillin. He had temporary improvement in nodule formation and subsequent healing with atrophic scars; however, after the completion of antibiotics, the nodules redeveloped and progressed distally down the leg.