Nocardia puris 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 N. puris.
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 N. puris 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−1 day−1) 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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