CC BY-NC-ND 4.0 · J Neurol Surg Rep 2021; 82(02): e21-e24
DOI: 10.1055/s-0040-1722345
Case Report

Diagnosis and Neurosurgical Management of Cerebral Nocardiosis

Carley Karam
1  Department of Surgery, Neurosurgery Clinical Clerkship, University of North Texas Health Science Center, Medical City Hospital, Fort Worth, Texas, United States
,
Abdolreza Siadati
1  Department of Surgery, Neurosurgery Clinical Clerkship, University of North Texas Health Science Center, Medical City Hospital, Fort Worth, Texas, United States
› Author Affiliations

Abstract

Primary Nocardia infections are uncommon gram-positive bacterial infections caused by aerobic actinomycetes and are typically regarded as opportunistic infections (only one-third of infected patients are immunocompetent). Risk factors include: glucocorticoid therapy, malignancy, organ transplant recipients, human immunodeficiency virus infections, tumor necrosis factor-α inhibitor therapy, diabetes mellitus, alcoholism, inflammatory bowel disease, chronic obstructive pulmonary disease, chronic granulomatous disease, and tuberculosis. The organism has a predisposition to disseminate to the central nervous system and can relapse or progress despite appropriate therapy. Treatment ranges from oral antibiotic management to multiple intravenous antibiotic therapy, with surgical intervention required for severe cases. The surgical options include aspiration or complete excision of abscess contents and capsule. In the present case, we describe the use of bilateral craniotomy with assisted image guidance and multiple abscess excision in an immunocompetent patient with systemic nocardiosis.



Publication History

Received: 06 December 2019

Accepted: 11 June 2020

Publication Date:
10 August 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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