Brain metastasis or nocardiosis? A case report of central nervous system Nocardiosis with a review of the literature

Autor:	Jaimin Patel, Mariam Goolam Mahomed, Hojin Sun
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Pathology medicine.medical_specialty Systemic disease Central nervous system Case Report 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine bacteremia Brain abscess Internal medicine key-words nocardiosis integumentary system biology business.industry Nocardiosis Nocardia bacterial infections and mycoses biology.organism_classification medicine.disease RC31-1245 brain abscess medicine.anatomical_structure Bacteremia bacteria business Brain metastasis
Zdroj:	Journal of Community Hospital Internal Medicine Perspectives, Vol 11, Iss 2, Pp 258-262 (2021) Journal of Community Hospital Internal Medicine Perspectives article-version (VoR) Version of Record
ISSN:	2000-9666
Popis:	Nocardiosis is an infection caused by the gram-positive bacterium Nocardia, which typically manifests as an isolated pulmonary or systemic disease. Of note, Nocardia has a predilection for the central nervous system (CNS) involvement, which is more commonly seen in systemic nocardiosis rather than as an isolated CNS infection. According to the Centers for Disease Control and Prevention, the estimated incidence of nocardiosis is only 500 to1000 cases in the USA every year, with cases mostly found in immunocompromised people, although infection in the immunocompetent may also occur. Here, we present a case of an immunocompromised patient who presented with neurologic symptoms and intracranial lesions initially concerning metastatic disease. Upon further investigation, the patient was found to have CNS nocardiosis with bacteremia. This is an extremely rare presentation given the lack of concurrent pulmonary and cutaneous involvement. The insidious onset and rarity of nocardiosis can result in a delayed or missed diagnosis. Early recognition is crucial as this is a potentially life-threatening illness. After obtaining adequate culture specimens, empiric treatment must be started expeditiously, keeping in mind the diversity of the Nocardia species and their antimicrobial resistance patterns.
Databáze:	OpenAIRE
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