Nocardia cyriacigeorgica as the causative agent of mandibular osteomyelitis (lumpy jaw) in a cat

An unusual case of osteomyelitis caused by Nocardia cyriacigeorgica infection and resulting in mandibular osteomyelitis and cellulitis (lumpy jaw) is described in a young cat. A 1-cm hard nodular mass was an incidental finding in the right mandible of a 14-month-old cat during routine physical examination. The lesion was fast growing, reaching up to 6 cm in its largest dimension over a 5-week period. A core biopsy of the affected mandible revealed foci of osteolysis, woven bone formation, and a few large clusters of filamentous bacteria surrounded by fine eosinophilic amorphous material bordered by neutrophils, plasma cells, macrophages, and occasional multinucleated giant cells. Pure cultures of acid-fast variable, Gram-positive filamentous bacteria were recovered on blood and chocolate agar plates at 48-hr postinoculation. On amplification and sequencing of the 16S ribosomal RNA and 65-kDa heat shock protein genes, the microorganisms were identified as N. cyriacigeorgica, within the actinomycetes.