Nocardial cerebral abscess: Report of three cases and review of the current neurosurgical management

Valarezo, Javier; Cohen, José E.; Valarezo, Luis; Spektor, Sergey; Shoshan, Yigal; Rosenthal, Guy; Umansky, Félix

doi:10.1179/016164103101201076

Cited by 31 publications

(27 citation statements)

References 8 publications

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“…The current knowledge base of bacteria that cause brain abscesses relies on cultures of pus specimens collected after neurosurgical drainage [1,27,28]. In this study, bacteria were microscopically observed in 45% of patients, whereas culturing on axenic media yielded bacteria in 80% of patients.…”

Section: Discussionmentioning

confidence: 98%

The Expansion of the Microbiological Spectrum of Brain Abscesses with Use of Multiple 16S Ribosomal DNA Sequencing

Raoult¹,

Masalma²,

Armougom³

et al. 2009

CLIN INFECT DIS

131

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Background. Brain abscess is commonly treated using empirically prescribed antibiotics. Thus, a comprehensive study of bacterial organisms associated with brain abscess is essential to define the best empirical treatment for this life-threatening condition. Methods. We prospectively compared cultures to single and multiple sequenced 16S ribosomal DNA polymerase chain reaction amplifications (by cloning and/or pyrosequencing) of cerebral abscesses in 20 patients from 2 hospitals in Marseilles, France, during the period January 2005 through December 2007. Results. The obtained cultures identified significantly fewer types of bacteria (22 strains) than did molecular testing (72 strains; P = .017, by analysis of variance test). We found that a patient could exhibit as many as 16 different bacterial species in a single abscess. The obtained cultures identified 14 different species already known to cause cerebral abscess. Single sequencing performed poorly, whereas multiple sequencing identified 49 species, of which 27 had not been previously reported in brain abscess investigations and 15 were completely unknown. Interestingly, we observed 2 patients who harbored Mycoplasma hominis (an emerging pathogen in this situation) and 3 patients who harbored Mycoplasma faucium, which, to our knowledge, has never been reported in literature. Conclusions. Molecular techniques dramatically increased the number of identified agents in cerebral abscesses. Mycoplasma species are common and should be detected in this situation. These findings led us to question the accuracy of the current empirical treatment of brain abscess.

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Section: Discussionmentioning

confidence: 98%

The Expansion of the Microbiological Spectrum of Brain Abscesses with Use of Multiple 16S Ribosomal DNA Sequencing

Raoult¹,

Masalma²,

Armougom³

et al. 2009

CLIN INFECT DIS

131

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“…However, the optimal treatment approach has not been established and nocardial brain abscesses have been managed either conservatively with stereotactic aspirations or with open craniotomy and enucleation [49,63,64]. Thus, each case needs a careful multidisciplinary evaluation by the primary physician, the infectious diseases specialist, and the surgeon.…”

Section: Treatmentmentioning

confidence: 98%

Nocardiosis: Updated Clinical Review and Experience at a Tertiary Center

2010

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Nocardiosis is a rare opportunistic disease that affects mainly patients with deficient cell-mediated immunity, such as those with acquired immunodeficiency syndrome (AIDS) or transplant recipients. Pulmonary disease is the most common presentation in immunosuppressed patients and approximately one-third have a disseminated disease. Primary cutaneous nocardiosis is more frequently observed in immunocompetent patients with direct inoculation of the organism through professional exposure. The diagnosis can be challenging, as signs and symptoms are not specific and a high index of clinical of suspicion is necessary. Although gram stain, modified acid-fast stain, and cultures remain as the standard diagnostic tools, novel molecular techniques have changed the taxonomy of these organisms and, in some instances, have facilitated their identification. The disease has a marked tendency to recur and a high morbidity and mortality rate in immunosuppressed patients. Treatment is usually prolonged and an associated antibiotic treatment is preferred for severe disease. Although sulfonamides in combination with other antibiotics are still the treatment of choice, other associations such as imipenem plus amikacin are preferred in some centers. Linezolid is a useful alternative therapeutic agent due to its oral availability and activity against most of the isolates studied. Twenty-eight cases of nocardiosis were diagnosed at our center between January 1989 and April 2009. We report the epidemiologic characteristics of Nocardia spp. observed in our institution and discuss the risk factors, clinical features, diagnosis, and management of the disease.

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“…These organisms also disseminate to other regions of the body, especially the central nervous system. Nocardial brain infections, which frequently manifest as brain abscesses [1,2], are well documented. Thus, nocardiae may be pathogens of the CNS [1e3].…”

Section: Introductionmentioning

confidence: 99%

An unusual murine behavior following infection with log-phase Nocardia asteroides type 6 strain GUH-2 (Nocardia cyriacigeorgica GUH-2)

Beaman¹,

Tam²

2008

Microbes and Infection

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Nocardial cerebral abscess: Report of three cases and review of the current neurosurgical management

Cited by 31 publications

References 8 publications

The Expansion of the Microbiological Spectrum of Brain Abscesses with Use of Multiple 16S Ribosomal DNA Sequencing

The Expansion of the Microbiological Spectrum of Brain Abscesses with Use of Multiple 16S Ribosomal DNA Sequencing

Nocardiosis: Updated Clinical Review and Experience at a Tertiary Center

An unusual murine behavior following infection with log-phase Nocardia asteroides type 6 strain GUH-2 (Nocardia cyriacigeorgica GUH-2)

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