1887

Abstract

Introduction:

is a rare cause of infection worldwide, with very few published cases. Here we report the first case to our knowledge of brain abscess caused by .

Case presentation:

Our patient, currently undergoing treatment with rituximab for non‐Hodgkin lymphoma, presented with a 2 week history of worsening headache and nuchal rigidity. Magnetic resonance imaging of the brain revealed a ring‐enhancing mass in the right temporal lobe. The abscess was surgically resected and the causative organism was identified as by culture and then 16S PCR of the rRNA gene. Our patient was successfully treated with a combination of imipenem and trimethoprim–sulfamethoxazole (15 mg kg day) for 3 months, followed by 9 months of monotherapy with trimethoprim–sulfamethoxazole.

Conclusion:

Treatment of nocardiosis remains challenging, with each species having a unique antimicrobial susceptibility profile. Our patient was successfully treated with a combination of imipenem and trimethoprim–sulfamethoxazole, followed by monotherapy with trimethoprim–sulfamethoxazole.

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2015-04-01
2019-10-21
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References

  1. Beaman B.L. , Burnside J. , Edwards B. , Causey W. . ( 1976; ). Nocardial infections in the United States, 1972–1974. . J Infect Dis 134:, 286–289.[CrossRef]
    [Google Scholar]
  2. Brown‐Elliott B.A. , Brown J.M. , Conville P.S. , Wallace R.J. Jr . ( 2006; ). Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. . Clin Microbiol Rev 19:, 259–282.[CrossRef]
    [Google Scholar]
  3. Brown‐Elliott B.A. , Biehle J. , Conville P.S. , Cohen S. , Saubolle M. , Sussland D. , Wengenack N. , Kriel K. , Bridge L. . other authors ( 2012; ). Sulfonamide resistance in isolates of Nocardia spp. from a US multicenter survey. . J Clin Microbiol 50:, 670–672.[CrossRef]
    [Google Scholar]
  4. CLSI ( 2008; ). Interpretive Criteria for Microorganism Identification by DNA Target Sequencing; Approved Guideline, Document MM18‐A. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  5. Conville P.S. , Witebsky F. . ( 2011; ). Nocardia, Rhodococcus, Gordonia, Actinomadura, Streptomyces, and other aerobic actinomycetes. . In Manual of Clinical Microbiology, 10th edn, pp. 515–542. Edited by Versalovic J. , Carroll K. C. , Funke G. , Jorgensen J. H. , Landry M. L. , Warnock D. W. . . Washington, DC:: ASM Press;.
    [Google Scholar]
  6. DSMZ ( 2013; ). Bacterial Nomenclature Up‐to‐Date (Approved Lists, Validation Lists). . http://www.dsmz.de/bacterial-diversity/prokaryotic-nomenclature-up-to-date.html
    [Google Scholar]
  7. Kilincer C. , Hamamcioglu M.K. , Simsek O. , Hicdonmez T. , Aydoslu B. , Tansel O. , Tiryaki M. , Soy M. , Tatman‐Otkun M. , Cobanoglu S. . ( 2006; ). Nocardial brain abscess: review of clinical management. . J Clin Neurosci 13:, 481–485.[CrossRef]
    [Google Scholar]
  8. Lai C.C. , Liu W.L. , Ko W.C. , Chen Y.H. , Tan H.R. , Huang Y.T. , Hsueh P.R. . ( 2011; ). Multicenter study in Taiwan of the in vitro activities of nemonoxacin, tigecycline, doripenem, and other antimicrobial agents against clinical isolates of various Nocardia species. . Antimicrob Agents Chemother 55:, 2084–2091.[CrossRef]
    [Google Scholar]
  9. Lowman W. , Aithma N. . ( 2010; ). Antimicrobial susceptibility testing and profiling of Nocardia species and other aerobic actinomycetes from South Africa: comparative evaluation of broth microdilution versus the Etest. . J Clin Microbiol 48:, 4534–4540.[CrossRef]
    [Google Scholar]
  10. Mamelak A.N. , Obana W.G. , Flaherty J.F. , Rosenblum M.L. . ( 1994; ). Nocardial brain abscess: treatment strategies and factors influencing outcome. . Neurosurgery 35:, 622–631.[CrossRef]
    [Google Scholar]
  11. Menendez R. , Cordero P.J. , Santos M. , Gobernado M. , Marco V. . ( 1997; ). Pulmonary infection with Nocardia species: a report of 10 cases and review. . Eur Respir J 10:, 1542–1546.[CrossRef]
    [Google Scholar]
  12. Munoz J. , Mirelis B. , Aragon L.M. , Gutierrez N. , Sanchez F. , Espanol M. , Esparcia O. , Gurgui M. , Domingo P. , Coll P. . ( 2007; ). Clinical and microbiological features of nocardiosis 1997–2003. . J Med Microbiol 56:, 545–550.[CrossRef]
    [Google Scholar]
  13. Reddy A.K. , Garg P. , Kaur I. . ( 2010a; ). Speciation and susceptibility of Nocardia isolated from ocular infections. . Clin Microbiol Infect 16:, 1168–1171.[CrossRef]
    [Google Scholar]
  14. Reddy A.K. , Garg P. , Kaur I. . ( 2010b; ). Spectrum and clinicomicrobiological profile of Nocardia keratitis caused by rare species of Nocardia identified by 16S rRNA gene sequencing. . Eye (Lond) 24:, 1259–1262.[CrossRef]
    [Google Scholar]
  15. Saubolle M.A. , Sussland D. . ( 2003; ). Nocardiosis: review of clinical and laboratory experience. . J Clin Microbiol 41:, 4497–4501.[CrossRef]
    [Google Scholar]
  16. Schlaberg R. , Fisher M.A. , Hanson K.E. . ( 2014; ). Susceptibility profiles of Nocardia isolates based on current taxonomy. . Antimicrob Agents Chemother 58:, 795–800.[CrossRef]
    [Google Scholar]
  17. Tan C.K. , Lai C.C. , Lin S.H. , Liao C.H. , Chou C.H. , Hsu H.L. , Huang Y.T. , Hsueh P.R. . ( 2010; ). Clinical and microbiological characteristics of nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998–2008. . Clin Microbiol Infect 16:, 966–972.[CrossRef]
    [Google Scholar]
  18. Uhde K.B. , Pathak S. , Mccullum I. Jr , Jannat‐Khah D.P. , Shadomy S.V. , Dykewicz C.A. , Clark T.A. , Smith T.L. , Brown J.M. . ( 2010; ). Antimicrobial‐resistant Nocardia isolates, United States, 1995–2004. . Clin Infect Dis 51:, 1445–1448.[CrossRef]
    [Google Scholar]
  19. Watanabe K. , Shinagawa M. , Amishima M. , Iida S. , Yazawa K. , Kageyama A. , Ando A. , Mikami Y. . ( 2006; ). First clinical isolates of Nocardia carnea, Nocardia elegans, Nocardia paucivorans, Nocardia puris and Nocardia takedensis in Japan. . Nihon Ishinkin Gakkai Zasshi 47:, 85–89.[CrossRef]
    [Google Scholar]
  20. Yassin A.F. , Straubler B. , Schumann P. , Schaal K.P. . ( 2003; ). Nocardia puris sp. nov. . Int J Syst Evol Microbiol 53:, 1595–1599.[CrossRef]
    [Google Scholar]
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