Infect Chemother.  2014 Mar;46(1):45-49. 10.3947/ic.2014.46.1.45.

Nocardia Brain Abscess in an Immunocompetent Patient

Affiliations
  • 1Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea. yspark@gilhospital.com
  • 2Department of Laboratory Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
  • 3Department of Neurosurgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
  • 4Department of Physiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.

Abstract

Nocardia cerebral abscess is rare, constituting approximately 1-2% of all cerebral abscesses. Mortality for a cerebral abscess of Nocardia is three times higher than that of other bacterial cerebral abscesses, therefore, early diagnosis and therapy is important. Nocardia cerebral abscess is generally occur among immunocompromised patients, and critical infection in immunocompetent patients is extremely rare. We report on a case of a brain abscess by Nocardia farcinica in an immunocompetent patient who received treatment with surgery and antibiotics. This is the second case of a brain abscess caused by N. farcinica in an immunocompetent patient in Korea.

Keyword

Nocardia infections; Brain abscess; Immunocompetence

MeSH Terms

Anti-Bacterial Agents
Brain Abscess*
Brain*
Early Diagnosis
Humans
Immunocompetence
Immunocompromised Host
Korea
Mortality
Nocardia Infections
Nocardia*
Anti-Bacterial Agents

Figure

  • Figure 1 Magnetic resonance imaging of brain. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.

  • Figure 2 (A) Yellowish, round colonies are found on a blood agar plate. (B) Gram-positive branched rods are observed (Gram stain, × 1000). (C) Modified acid-fast stain of a pus specimen (× 1000), shows branching, filamentous organism compatible with Nocardia species (white arrows).


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