Nocardia Farcinica brain abscess in an immunocompetent old patient: A case report and review of literature

Chaudhari, Dinesh; Renjen, Pushpendra Nath; Sardana, Raman; Butta, Hena

doi:10.4103/aian.aian_263_17

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…Chaudhari et al reported brain abscess in an immunocompetent individual. 13 A case of brain abscess because of N. farcinica has been reported in a patient of chronic demyelinating neuropathy on steroid therapy from Kerala. 14 The present case also had multiple brain abscesses by N. farcinica.…”

Section: Discussionmentioning

confidence: 99%

Disseminated nocardiasis by Nocardia farcinica: Review and first case report from Central India

Bhargava

Kombade

Dash

et al. 2019

Medical Journal Armed Forces India

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Section: Discussionmentioning

confidence: 99%

Disseminated nocardiasis by Nocardia farcinica: Review and first case report from Central India

Bhargava

Kombade

Dash

et al. 2019

Medical Journal Armed Forces India

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“…In addition, to prevent treatment delay, early surgical intervention is required. [ 3 14 ] To treat a nocardial brain abscess, craniotomy with evacuation of the abscess, as well as collection of a specimen for culture to further assess drug sensitivity, is essential for successful treatment. In our review, surgery was undertaken in five patients (surgical resection in four patients; aspiration in one patient).…”

Section: Discussionmentioning

confidence: 99%

Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy

Shimizu¹,

Tsuchiya²,

Fujisawa³

2019

Surg Neurol Int

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Background:Nocardia species are ubiquitous in nature and mainly cause pulmonary disease in humans; however, they can also infect the central nervous system and skin. The management of cerebellar nocardiosis is troublesome and requires multiple considerations of the severity of the underlying systemic disease, difficulties in identifying the bacterium, and frequent delay in initiating adequate therapy.Case Description:We report a 52-year-old diabetic female patient with Nocardia paucivorans cerebellar abscesses. Brain magnetic resonance imaging (MRI) revealed innumerable small ring-enhancing lesions of posterior fossa. In this report, we present a case of primary single cerebellar abscesses due to N. paucivorans. Early diagnosis and surgical interventions were significant for the patient. The diagnosis was confirmed by DNA sequencing and the organism was susceptible to trimethoprim–sulfamethoxazole (TMP/SMX). The patient was successfully treated with drugs and surgical excision.Conclusion:According to the literature, surgical excision or aspiration of cerebellar abscess seems to provide favorable outcomes. In our experience, a successful outcome was achieved with subtotal resection and prolonged adequate antibiotic therapy.

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“…Table 1 demonstrates that 10 (59%) of 17 cases of nocardial brain abscesses showed true restricted diffusion, i.e., hyperintensity on DWI and low signal on ADC maps. 1,6,11,21,27,32,36,39,41,42,46,47,[51][52][53][54] High signal intensity on DWI with low ADC values for cerebral abscesses was first reported by Ebisu et al, 15 with many subsequent studies reporting similar findings. 18,20 In a meta-analysis Xu et al 50 found that DWI had a high sensitivity (0.95) and specificity (0.94) for differentiating brain abscesses from other cystic brain masses, showing it is a reliable method in detecting pyogenic brain abscesses.…”

Section: The Role Of Neuroimaging In Brain Abscessesmentioning

confidence: 97%

Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases

Quinoa¹,

Jumah²,

Narayan³

et al. 2019

Neurosurgical Focus

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Central nervous system infections in immunosuppressed patients are rare but potentially lethal complications that require swift diagnoses and intervention. While the differential diagnosis for new lesions on neuroradiological imaging of immunosuppressed patients typically includes infections and neoplasms, image-based heuristics to differentiate the two has been shown to have variable reliability.The authors describe 2 rare CNS infections in immunocompromised patients with atypical physical and radiological presentations. In the first case, a 59-year-old man, who had recently undergone a renal transplantation, was found to have multifocal Nocardia amikacinitolerans abscesses masquerading as neoplasms on diffusion-weighted imaging (DWI); in the second case, a 33-year-old man with suspected recurrent Hodgkin’s lymphoma was found to have a nonpyogenic abscess with cytomegalovirus (CMV) encephalitis.As per review of the literature, this appears to be the first case of brain abscess caused by N. amikacinitolerans, a recently isolated superbug. Despite confirmation through brain biopsy later on in case 1, the initial radiological appearance was atypical, showing subtle diffusion restriction on DWI. Similarly, the authors present a case of CMV encephalitis that presented as a ring-enhancing lesion, which is extremely rare. Both cases draw attention to the reliability of neuroimaging in differentiating an abscess from a neoplasm.

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Nocardia Farcinica brain abscess in an immunocompetent old patient: A case report and review of literature

Cited by 13 publications

References 19 publications

Disseminated nocardiasis by Nocardia farcinica: Review and first case report from Central India

Disseminated nocardiasis by Nocardia farcinica: Review and first case report from Central India

Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy

Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases

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