Multiple nocardial abscesses of cerebrum, cerebellum and spinal cord, causing quadriplegia

Durmaz, Ramazan; Atasoy, Metin Ant; Durmaz, Gül; Adapınar, Baki; Arslantaş, Ali; Aydinli, Aydin; Tel, Eşref

doi:10.1016/s0303-8467(00)00123-2

Cited by 33 publications

(34 citation statements)

References 7 publications

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“…Nocardial involvement of the CNS, in particular the spinal cord and meningeal layers, is exceedingly rare with only a handful of tissue and culture-confirmed cases in the literature [9][10][11][12][13][14][15] . We searched the literature for nocardia infection of the spinal cord and the spinal meninges and summarize the location, therapy and follow-up results in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…We searched the literature for nocardia infection of the spinal cord and the spinal meninges and summarize the location, therapy and follow-up results in Table 1. Nocardial involvement of the spinal cord occurs predominately in the immunocompromised population [7,9,10,[13][14][15] with only one case of an isolated spinal cord intramedullary nocardial abscess in an immunocompetent patient [12] ; however, there no evidence that formal immune testing was performed [8,11] . In the majority of cases, there was a co-existing pulmonary nocardial infective focus which was likely to represent the primary site prior to CNS dissemination [9,11,13,14] .…”

Section: Discussionmentioning

confidence: 99%

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Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Sharma

Anthony

Hsu

et al. 2015

European Journal of Case Reports in Internal Medicine

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Disseminated nocardiosis of the central nervous system (CNS) has been rarely reported, especially in the immunocompetent patient. We report a case of cerebral and cervical intradural extramedullary nocardiosis likely to have been the result of disseminated spread from a pulmonary infective focus. Attempts at tissue biopsy and culture of the initial cerebral and pulmonary lesions both failed to yield the diagnosis. Interval development of a symptomatic intradural extramedullary cervical lesion resulted in open biopsy and an eventual diagnosis of nocardiosis was made. We highlight the diagnostic dilemma and rarity of spinal nocardial dissemination in an immunocompetent individual. LEARNING POINTS• Disseminated nocardiosis can occur in immunocompetent patents.• Systemic manifestations of sepsis suggested an infective aetiology.• When disseminated lesions are found, tissue diagnosis Is vital in directing management; in this case, biopsies were taken from both thoracic and spinal lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Sharma

Anthony

Hsu

et al. 2015

European Journal of Case Reports in Internal Medicine

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“…Los abscesos cerebrales nocardiales siguen constituyendo un desafío diagnóstico y terapéutico, estando asociados a altos índices de mortalidad, especialmente en pacientes inmunocomprometidos 1,5,8,9 . La localización supratentorial es más frecuente que la infratentorial.…”

Section: Discusionunclassified

“…Entre mil cincuenta casos de nocardiosis seleccionados al azar de la literatura, 22,7% de los pacientes desarro l l a ro n subsiguientes infecciones secundarias del SNC 1 . Mamelak et al han estimado que el riesgo puede llegar a 45% [5][6][7][8] . Dado el carácter silente que pueden tener las localizaciones neurológicas y su elevada fre c u e ncia, se aconseja realizar TAC y/o RM de cráneo siempre que se diagnostica nocardiosis pulmonar.…”

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Absceso recidivante por Nocardia asteroides en una paciente portadora de poliglobulia primaria

Aboal

Salamano

Braselli³

et al. 2006

Arq. Neuro-Psiquiatr.

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La nocardiosis del sistema nervioso central (SNC) es una enfermedad poco común, cuya frecuencia ha aumentado con el crecimiento de los tratamientos inmunosupresores. El hombre se infecta por inhalación, inoculación traumática cutánea directa y tras una infección periodontal ingiriendo alimentos contaminados. La localización pulmonar es la más frecuente, siendo la fuente inicial de diseminación hemática, con predominio en piel, tejido celular subcutáneo y SNC. Es conocida la predilección de Nocardia por el SNC. Estos abscesos, asociados a altos índices de mortalidad, especialmente en pacientes inmunocomprometidos, siguen constituyendo un desafío diagnóstico y terapéutico, permaneciendo no aclarado su manejo terapéutico óptimo. A pesar de la controversia en cuanto al manejo quirúrgico de estas lesiones, el diagnóstico precoz, por aspiración esterotáxica, y la iniciación de una terapia antimicrobiana son esenciales para la buena evolución del paciente. Se presenta una paciente portadora de una poliglobulia primaria, con absceso cerebral recidivante por Nocardia asteroides de posible origen dentario.

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Spinal infections

Tali

G�ltekin

2004

Eur Radiol

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Spinal infections have an increasing prevalence among the general population. Definitive diagnosis based solely on clinical grounds is usually not possible and radiological imaging is used in almost all patients. The primary aim of the authors is to present an overview of spinal infections located in epidural, intradural and intramedullary compartments and to provide diagnostic clues regarding different imaging modalities, particularly MRI, to the practicing physicians and radiologists.

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Multiple nocardial abscesses of cerebrum, cerebellum and spinal cord, causing quadriplegia

Cited by 33 publications

References 7 publications

Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Absceso recidivante por Nocardia asteroides en una paciente portadora de poliglobulia primaria

Spinal infections

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