| Autor: |
Liu HJ; MB MCh BAO, Foundation Year 1 Doctor, Department of Medicine, Mater Infirmorum Hospital, Belfast., Simms HN; Consultant Neurosurgeon, Neurosurgery Unit, Royal Victoria Hospital, Belfast., Herron B; Consultant Neuropathologist, Neuropathology Department, Royal Victoria Hospital, Belfast., Hedderwick S; Consultant in Infectious Diseases, Infectious Disease Service, Royal Victoria Hospital, Belfast., Loughrey A; Consultant Microbiologist, Department of Microbiology, Royal Victoria Hospital, Belfast., Lindsay JR; Consultant Physician (Endocrinology & Diabetes), Department of Medicine, Mater Infirmorum Hospital. |
| Abstrakt: |
Nocardiosis, a rare infection occurring mostly in immunosuppressed patients can present with neurological complications including cerebral abscess formation, and is associated with high morbidity and mortality. We describe the case of a 54-year-old immunocompetent man with cerebral nocardiosis, who presented with sudden onset hemiparesis in an acute medicine unit. He required three craniotomies with excision, following failure to respond to antimicrobial therapy, with subsequent clinical improvement and radiological resolution of multiple cerebral abscesses. Challenges in diagnosis and management of hemiparesis in the acute medical unit are discussed. Successful management of cerebral nocardiosis require early communication with a neurosurgical unit, neuropathology and microbiology services to optimise management with targeted antimicrobial therapy. |
