Concurrent double infections of the skin: Phaeohyphomycosis and nocardiosis in a patient with idiopathic thrombocytopenic purpura

We describe a case of concurrent double infection with phaeohyphomycosis and lymphocutaneous nocardiosis in an immunocompromised host. The episode occurred almost simultaneously with an incident of insect bites. Exophiala spinifera was isolated from lesions on the left arm and Nocardia asteroides was isolated from lesions on the right hand. Clinical resolution occurred within 5 months after initiation of antimicrobial treatment with oral itraconazole and minocycline. We believe that this case represents a novel episode of previously unreported concurrent infections with phaeohyphomycosis and lymphocutaneous nocardiosis in human beings.