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DOI: 10.1055/s-0040-1719124
Brain Abscess Caused by Nocardia: Case Report and Literature Review
Abscesso Cerebral causado por Nocardia: Relato de Caso e Revisāo da Literatura![](https://www.thieme-connect.de/media/10.1055-s-00028832/202103/lookinside/thumbnails/10-1055-s-0040-1719124_2000091-1.jpg)
Abstract
Nocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.
Resumo
Abscesso cerebral por Nocardia é uma entidade rara, correspondendo a 2% dos abscessos cerebrais. Quando comparada a abscessos causados por outras bactérias, apresenta morbimortalidade 3 vezes maior. Adequada investigação e tratamento, caracterizado por antibioticoterapia prolongada, são cruciais para desfecho favorável dos pacientes. Os autores descrevem um caso de uma paciente sem comorbidades neurológicas prévias que apresentou sinais de comprometimento do lobo occipital direito e crises convulsivas, cuja investigação demonstrou tratar-se de abscesso cerebral por Nocardia spp. A paciente foi tratada cirurgicamente seguida de antibioticoterapia prolongada, com ótima evolução ao longo de 1 ano de acompanhamento.
Note
The patient has consented to the submission of the case report to the journal.
Publication History
Received: 25 August 2020
Accepted: 25 September 2020
Article published online:
26 November 2020
© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Herrero Martínez JA, Gómez Gómez J, García Vázquez E, Hernández Torres A. Nocardiosis. Med - Programa Form Médica Continuada Acreditado [Internet]. 2014; 11 (58) 3412-3418 . Available from: http://linkinghub.elsevier.com/retrieve/pii/S0304541214707930
- 2 Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev 1994; 7 (02) 213-264
- 3 Lerner PI. Nocardiosis. Clin Infect Dis 1996; 22 (06) 891-903 , quiz 904–905
- 4 Tamarit M, Poveda P, Barón M, Del Pozo JM. Four cases of nocardial brain abscess. Surg Neurol Int 2012; 3: 88 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463145/
- 5 Kennedy KJ, Chung KHC, Bowden FJ. et al. A cluster of nocardial brain abscesses. Surg Neurol 2007; 68 (01) 43-49 , discussion 49
- 6 Yaakup NA, Rahmat K, Ramli N, Sia SF. Cerebral nocardiosis in an immunocompetent patient: A diagnostic dilemma. Eur J Radiol Extra 2009; 71 (02) 47-51
- 7 Brouwer MC, Tunkel AR, McKhann II GM, van de Beek D. Brain abscess. N Engl J Med 2014; 371 (05) 447-456 http://www.nejm.org/doi/abs/10.1056/NEJMra1301635
- 8 Kilincer C, Hamamcioglu MK, Simsek O. et al. Nocardial brain abscess: review of clinical management. J Clin Neurosci 2006; 13 (04) 481-485 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16678731
- 9 Malincarne L, Marroni M, Farina C. et al. Primary brain abscess with Nocardia farcinica in an immunocompetent patient. Clin Neurol Neurosurg 2002; 104 (02) 132-135
- 10 Mamelak AN, Obana WG, Flaherty JF, Rosenblum ML, Holtom PD. Nocardial brain abscess: treatment strategies and factors influencing outcome. Neurosurgery 1994; 35 (04) 622-631
- 11 Reddy JS, Mishra AM, Behari S. et al. The role of diffusion-weighted imaging in the differential diagnosis of intracranial cystic mass lesions: a report of 147 lesions. Surg Neurol 2006; 66 (03) 246-250 , discussion 250–251
- 12 Fleetwood IG, Embil JM, Ross IB. Nocardia asteroides cerebral abscess in immunocompetent hosts: report of three cases and review of surgical recommendations. Surg Neurol 2000; 53 (06) 605-610
- 13 Embil JM, Halliday WC, Nath A. Primary cerebellar T-cell lymphoma with acquired immunodeficiency syndrome. J Neurovirol 1997; 3 (03) 229-232
- 14 Chen ST, Tang LM, Ro LS. Brain abscess as a complication of stroke. Stroke 1995; 26 (04) 696-698
- 15 Börm W, Gleixner M. Nocardia brain abscess misinterpreted as cerebral infarction. J Clin Neurosci 2003; 10 (01) 130-132