Nocardia farcinica meningitis in a patient with high-grade astrocytoma

Nasri, Elahe; Fakhim, Hamed; Barać, Aleksandra; Yousefi, Saber; Aghazade, Kouros; Boljević, Darko; Mardani, Massoud

doi:10.3855/jidc.11582

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Nocardial meningitis is an infrequent manifestation of CNS nocardiosis and can occur with or without an associated brain abscess. [ 15 ] In our case, the patient initially had only a headache and fever, which could be easily neglected. Therefore, the neurological examination is essential since the patient showed remarkably meningeal irritation.…”

Section: Discussionmentioning

confidence: 75%

Central nervous system nocardiosis in a 54-year-old man with lateral ventricular choroid plexitis and diffused meningitis: A case report

Yu,

Dai,

Pang

2024

Medicine

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Introduction: Nocardiosis is an unusual infection caused by aerobic gram-positive bacteria in the genus Nocardia. Infections resulting from Nocardia species are frequent in immunosuppressive patients. Weakened immune systems caused by human immunodeficiency virus infection, diabetes, cancer, and other conditions such as chronic lung disease, renal failure, etc, are the main risk factors for nocardiosis. Central nervous system (CNS) nocardiosis has been reported to represent ~2% of all and to be present in 15% to 50% of patients with systemic infection. The patient in our case had an isolated CNS nocardiosis caused by Nocardia terpenica infection, a rare reclassified Nocardia pathogen of CNS nocardiosis. Case: We here present a 54-year-old Chinese male with a fever and headache for 15 days who showed positive meningeal irritation signs. Magnetic resonance imaging showed the right trigone of the lateral ventricular choroid plexitis and diffused leptomeningeal meningitis involving the bilateral cerebral hemisphere, cerebellar hemisphere, and brain stem. The patient was quickly diagnosed with CNS Nocardia infection by next-generation sequencing within 48 hours after admission. Meanwhile, the diagnosis was validated by Nocardia-positive staining in cerebral spinal fluid culturing. The patient was given trimethoprim-sulfamethoxazole, and his symptoms recovered after 3 days. Conclusions: In this case, the clinical, radiological, and microbiological findings highlight the importance of suspecting Nocardia as the potential pathogen in patients with central nervous system inflammation of doubted immune incompetence. In addition, next-generation sequencing as an effective test is also highly recommended for suspicious CNS infection patients to perform a rapid diagnosis and treatment.

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Section: Discussionmentioning

confidence: 75%

Central nervous system nocardiosis in a 54-year-old man with lateral ventricular choroid plexitis and diffused meningitis: A case report

Yu,

Dai,

Pang

2024

Medicine

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“…, according to a PubMed search (keywords: [pleural or empyema or pleuritis] and Nocardia farcinica; time period from inception to March 2021)[2][3][4][5][6][7][8][9][10][11][12][13][14]. The general series of nocardiosis briefly mention a few additional cases of pleural involvement by N. farcinica, but with information so incomplete that they cannot be incorporated into this review.…”

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confidence: 99%

Pleural Infection Caused by Nocardia farcinica: Two Cases and Review of the Literature

Bagüeste

Porcel

2021

Cureus

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Meningitis and spondylodiscitis due to Nocardia nova in an immunocompetent patient

et al. 2023

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Background Disseminated nocardiosis is a very rare disease. By now only few cases of meningitis and spondylodiscitis have been reported. To our knowledge, this is the first case of meningitis caused by Nocardia nova. Case presentation We report on a case of bacteraemia, meningitis and spondylodiscitis caused by N. nova in an immunocompetent patient. We describe the long, difficult path to diagnosis, which took two months, including all diagnostic pitfalls. After nocardiosis was diagnosed, intravenous antibiotic therapy with ceftriaxone, later switched to imipenem/cilastatin and amikacin, led to rapid clinical improvement. Intravenous therapy was followed by oral consolidation with co-trimoxazole for 9 months without any relapse within 4 years. Conclusions Establishing a diagnosis of nocardiosis is a precondition for successful antibiotic therapy. This requires close communication between clinicians and laboratory staff about the suspicion of nocardiosis, than leading to prolonged cultures and specific laboratory methods, e.g. identification by 16S rDNA PCR.

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Nocardia farcinica meningitis in a patient with high-grade astrocytoma

Cited by 3 publications

References 11 publications

Central nervous system nocardiosis in a 54-year-old man with lateral ventricular choroid plexitis and diffused meningitis: A case report

Central nervous system nocardiosis in a 54-year-old man with lateral ventricular choroid plexitis and diffused meningitis: A case report

Pleural Infection Caused by Nocardia farcinica: Two Cases and Review of the Literature

Meningitis and spondylodiscitis due to Nocardia nova in an immunocompetent patient

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