Meningitis and Ventriculitis due to &lt;i&gt;Nocardia araoensis&lt;/i&gt; Infection

Yamashita, Satoshi; Kawano, Hiroyuki; Tanigawa, Tetsuya; Mihara, Yosuke; Gonoi, Toru; Ando, Yumiko

doi:10.2169/internalmedicine.56.7332

Cited by 17 publications

(11 citation statements)

References 20 publications

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“…Absence of abscess formation and relatively benign clinical course in our patient may suggest that N. terpenica is not a very virulent strain of Nocardia species, which may be explained by the finding that evolutionarily N. terpenica is far away from those highly virulent strains such as N. asteroides, N. farcinica, N. otitidiscaviarum, and N. paucivorans ( Figure 2C) (16,17). It has been pointed out that Nocardia meningitis is difficult to diagnose due to the fact that CNS nocardiosis is relatively infrequently seen in clinics; in addition, Nocardia species grow very slowly making the diag-nosis be missed sometimes.…”

Section: Discussionmentioning

confidence: 79%

The First Report of Cerebral Nocardiosis Caused by Nocardia terpenica Together With Exiguobacterium profundum Bacteremia

Zou

Cai

et al. 2018

Jundishapur J Microbiol

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Introduction: With the widespread use of antibiotics and increasing number of immunocompromised patients, many rare bacterial infections have become increasing. Recently, only a few cases showed central nervous system (CNS) nocardiosis and Exiguobacterium bacteremia. However, the case that CNS nocardiosis together with Exiguobacterium bacteremia has never been reported. Case Presentation: The patient was admitted to a tertiary hospital with CNS infection symptoms. Cerebrospinal fluid and blood were both sent to culture. Pathogens were both isolated from cerebrospinal fluid and blood, following 16s rRNA sequencing, which were finally identified as Nocardia and Exiguobacterium species. Conclusions: It is the first reported case of CNS Nocardia terpenica infection in a patient without abscess formation in the CNS. Additionally, this patient also had a complex infection involving Exiguobacterium profundum bacteremia.

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Section: Discussionmentioning

confidence: 79%

The First Report of Cerebral Nocardiosis Caused by Nocardia terpenica Together With Exiguobacterium profundum Bacteremia

Zou

Cai

et al. 2018

Jundishapur J Microbiol

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“…In the histopathological diagnosis of cerebral actinomycosis, differentiation from nocardiosis is important, because the therapeutic modalities for these two disorders are different 3,6,7,12 . The majority of cases of nocardiosis are caused by infection of Nocardia asteroides or Nocardia brasiliensis , 13 but rare cases of brain abscess caused by Nocardia wallacei 14 or Nocardia araoensis 15 have also been reported. Nocardiosis tends to more frequently develop brain abscesses than actinomycosis 3,5,13 .…”

Section: Discussionmentioning

confidence: 99%

Acute actinomycotic brain abscess in a patient with rheumatoid arthritis

et al. 2020

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An autopsy case of acute actinomycotic brain abscess involving a patient with rheumatoid arthritis (RA) is reported. The patient was a 72-year-old man with a sevenyear history of RA and pulmonary complications, who acutely developed dysarthria and dysphagia three days before death. Autopsy revealed a fresh, non-encapsulated abscess in the "late cerebritis" stage, measuring 2 cm in diameter, in the white matter of the right parietal lobe. A small number of tiny "sulfur granules" consisting of numerous filamentous bacilli were found within the abscess. The abscess had ruptured to the lateral ventricle and elicited ventriculitis, and mild acute purulent leptomeningitis was also observed. The lung showed chronic interstitial pneumonia/pulmonary fibrosis with bronchiectasis and emphysema, and large sulfur granules were found in the lumens of a few bronchi. Less than 5% of patients with actinomycotic infection develop central nervous system lesions, and actinomycotic brain abscesses make up only 0.6% of all brain abscesses. Actinomycotic brain abscesses usually pursue a protracted clinical course, and well-formed pyogenic membranes are commonly observed. The present case is exceptional in that the very early stage of the cerebral abscess formation was pathologically captured.

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“…There are only a few case reports with N. araoensis causing meningitis[11] and pulmonary[7] and skin diseases. [12] The presentation may vary on the location of involvement.…”

Section: Discussionmentioning

confidence: 99%

Nocardia araoensis causing brain abscess

et al. 2019

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Nocardial brain abscess is a rare central nervous system infection with high morbidity and mortality. Most of the human infections, i.e., about 90%, are due to Nocardia asteroides group comprising N. asteroides complex, Nocardia farcinica , and Nocardia nova . Other species rarely cause human infections. Here, we report a case of left parieto-occipital abscess caused by a rare species, Nocardia araoensis , its diagnosis, treatment options, and review of literature. A 73-year-old male, known case of diabetes mellitus, on prolonged oral corticosteroid for autoimmune hemolytic anemia presented with a 1-month history of memory deficit and gait imbalance. On examination, he had a right inferior quadrantanopia and hemiparesis. Magnetic resonance imaging showed a multiloculated ring-enhancing lesion in the left parieto-occipital region. Navigation-assisted biopsy was done. The organism isolated was N. araoensis . He was treated successfully with prolonged course of antibiotics which resulted in complete clinical and radiological resolution. N. araoensis is a rare cause of brain abscess and needs to be suspected in immunocompromised individuals. Early diagnosis and prolonged treatment can result in complete clinical and radiological resolution.

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Meningitis and Ventriculitis due to <i>Nocardia araoensis</i> Infection

Cited by 17 publications

References 20 publications

The First Report of Cerebral Nocardiosis Caused by Nocardia terpenica Together With Exiguobacterium profundum Bacteremia

The First Report of Cerebral Nocardiosis Caused by Nocardia terpenica Together With Exiguobacterium profundum Bacteremia

Acute actinomycotic brain abscess in a patient with rheumatoid arthritis

Nocardia araoensis causing brain abscess

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