CNS Nocardiosis

Smith, Philip W.; Steinkraus, Gregory E.; Henricks, Bruce W.; Madson, Everett C.

doi:10.1001/archneur.1980.00500600077017

Cited by 28 publications

(2 citation statements)

References 15 publications

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“…Alternative antimicrobial agents, such as carbapenems, cephalosporins, aminoglycosides, quinolones, macrolides or tetracyclines, can be used in patients who cannot tolerate sulfa drugs or for resistant microorganisms [ 6 ]. The treatment regimen recommended for patients with CNS nocardiosis include parenteral trimethoprim-sulfamethoxazole (TMP/SMX, 10-20 mg/kg/d in three, divided doses over 24 hours) with imipenem 500 mg qid and amikacin 15 mg/kg/d if other organs are involved for at least six weeks [ 9 ]. Certain Nocardia species are resistant to amikacin; therefore, Linezolid can be used instead [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Certain Nocardia species are resistant to amikacin; therefore, Linezolid can be used instead [ 1 ]. If the patient shows clinical and radiological improvement with the intravenous regimen, treatment can be converted to two-drug oral therapy [ 9 ]. Although the optimum duration of antibiotic therapy is uncertain, long-term suppressive therapy is strongly recommended.…”

Section: Discussionmentioning

confidence: 99%

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Diffuse Nocardial Spinal Subdural Empyema: Diagnostic Dilemma and Treatment Options

Aljuboori

Sharma

Altstadt

2017

Cureus

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Nocardiosis of the central nervous system and spine, in particular, is a rare infection with significant morbidity and mortality. Treatment is usually with antibiotics and surgical drainage or biopsy. The authors report a case of a 49-year-old man who presented with chronic lower back pain and paraplegia. He was found to have spinal subdural empyema caused by Nocardia farcinica. Laminectomy and sampling of the subdural collection were performed, and the patient was treated with triple intravenous antibiotics (linezolid, amikacin and ciprofloxacin). There was no neurological recovery at follow-up. Spinal nocardiosis should be considered in the differential diagnosis of immunocompromised patients who present with diffuse spinal epidural/subdural or spinal cord abscesses, appropriately unresponsive to antibiotics. Our case provides an insight into the management challenges of this rare disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%