A Dead Case Report From Brain Abscess Caused by Nocardia Farcinica

Abstract

Background: Brain abscess due to the Nocardia genus is rarely reported and it is usually found in immunocompromised patients. Treatment of Nocardia brain abscess is troublesome and requires consideration of the severity of the underlying systemic disease. The difficulties in identifying the bacterium and the frequent delay in initiating adequate therapy often influence the prognosis of patients.Case presentation: Here, we report a rare case of brain abscess caused by Nocardia farcinica. The patient’s medical history was complicated, he was hospitalized for several times, but no pathogens were found. At last, bacterial was found in culture of brain abscess puncture fluid, the colony was identified as Nocardia farcinica by mass spectrometry. Targeted antibiotic treatment was implemented, brain abscess tended to alleviate, but the patient eventually developed fungal pneumonia and died of acute respiratory distress syndrome (ARDS). Conclusion: brain abscess caused by Nocardia farcinica can be appear in non-immunocompromised individuals. Early diagnosis, reasonable surgical intervention, and targeted antibiotic treatment are critical for Nocardia brain abscess treatment. In the treatment of Nocardia brain abscess, we should pay attention to the changes of patients' immunity and avoid infection with other pathogens, especially fungi.