An unusual case of <i>Nocardia cyriacigeorgica</i> presenting with spinal abscesses in a renal transplant recipient and a review of the literature

Freiberg, Jeffrey A.; Saharia, Kapil; Morales, Megan

doi:10.1111/tid.13025

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…Infection due to N. brasiliensis is rare compared with that due to other species, which generally results from direct traumatic inoculation into the skin and hematogenous spread from the primary location to the central nervous system where a brain abscess is formed. However, rare cases of meningitis or spinal abscess caused by N. brasiliensis have also been reported [8].…”

Section: Discussionmentioning

confidence: 99%

A clinical case report of brain abscess caused by Nocardia brasiliensis in a non-immunocompromised patient and a relevant literature review

et al. 2020

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Background Brain abscess due to the Nocardia genus is rare and usually found in immunocompromised patients. The most common subtype implicated is Nocardia farcinica while brain abscess due to Nocardia brasiliensis is comparatively rare. Diagnosis of brain abscess is based mainly on bacteriological culture from pus collected at the site of infection, and brain imaging. Stereotaxic aspiration or surgical resection combined with adequate duration of treatment with antibiotics to which the bacteria are sensitive represent effective treatment strategies. Case presentation We report a rare case of brain abscess caused by Nocardia brasiliensis in a non-immunocompromised patient. He admitted to our hospital twice with a headache. Stereotaxic aspiration was performed at the patient’s first appointment at the hospital, and a craniotomy was used to excise the lesion during subsequent abscess recurrence. Conclusion Early diagnosis, reasonable surgical intervention, and adequate duration of treatment with effective antibiotics are critical for treating brain abscess.

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Section: Discussionmentioning

confidence: 99%

A clinical case report of brain abscess caused by Nocardia brasiliensis in a non-immunocompromised patient and a relevant literature review

et al. 2020

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“…4). Upon careful review, 13 articles published between 2010 and 2018 met the studies inclusion/exclusion criteria, [16][17][18][19][20][21][22][23][24][25][26][27][28] including 2 case series, 10 case reports, and 1 case-control study (Table 1). These studies featured a total of 67 patients, of whom 40 met inclusion criteria (mean age, 47 years; range, 17 to 80 years; 67.8% males).…”

Section: Discussionmentioning

confidence: 99%

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Hatter¹,

Beyer²,

Camino-Willhuber³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant. OBSERVATIONS PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality. LESSONS Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. Aspergillus species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of Aspergillus infection is projected to rise in the coming years.

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“…38,184,188 Similarly, N. asiatica 33 and N. farcinica have a proclivity for CNS involvement. 34,178,185,189 Bone Bone involvement is rare in nocardiosis, but spine abscesses, 190 epidural abscesses, 191 paravertebral abscesses, 112 mycetomas of the feet, 168 osteomyelitis, 192 and septic arthritis 100,193 have been described. Sternal wound infections due to N. farcinica were reported in one hospital in a 13-month period; transmission from an anesthesiologist was confirmed by identical ribotype patterns.…”

Section: Clinical Features Pulmonarymentioning

confidence: 99%

Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

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AbstractMembers of the Nocardia genus are ubiquitous in the environment. These aerobic, gram-positive organisms can lead to life-threatening infection, typically in immunocompromised hosts such as solid organ transplant recipients or those receiving immunosuppressive medications for other reasons. This current review discusses the microbiology of nocardiosis, risk factors for infection, clinical manifestations, methods for diagnosis, and treatment. Nocardiosis primarily affects the lung but may also cause skin and soft tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs. Although rare as a cause of community-acquired pneumonia, Nocardia can have severe morbidity and mortality, particularly in patients with comorbidities or compromised immunity. Early diagnosis and timely initiation of therapy are critical to optimizing patient outcomes. Species identification is important in determining treatment, as is in vitro susceptibility testing. Sulfonamide therapy is usually indicated, although a variety of other antimicrobials may be useful, depending on the species and susceptibility testing. Prolonged therapy is usually indicated, for 6 to 12 months, and in some cases surgical debridement may be required to resolve infection.

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An unusual case of Nocardia cyriacigeorgica presenting with spinal abscesses in a renal transplant recipient and a review of the literature

Cited by 8 publications

References 41 publications

A clinical case report of brain abscess caused by Nocardia brasiliensis in a non-immunocompromised patient and a relevant literature review

A clinical case report of brain abscess caused by Nocardia brasiliensis in a non-immunocompromised patient and a relevant literature review

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Nocardia spp.: A Rare Cause of Pneumonia Globally

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