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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1813712
Review Article

Isolated Cerebellar Abscess by Nocardia cyriacigeorgica in an Immunocompetent Patient: A Case Report and Systematic Review

Authors

  • Maria Isabel Ocampo-Navia

    1   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia

  • Felipe Marín Navas

    1   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia

  • Alex Taub-Krivoy

    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia

  • Sergio Esteban Chacón

    1   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia

  • Daniela Castaño

    1   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia

  • Oscar Fernando Zorro

    1   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
    2   Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia
    3   Department of Neurosurgery, Hospital Universitario San Ignacio, Bogotá, Colombia
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Abstract

Nocardia is a Gram-positive bacillus characterized by branching filaments, accounting for approximately 2% of all cerebral abscesses. It predominantly affects immunocompromised individuals. Central nervous system nocardiosis is less frequently reported and carries a poorer prognosis. Clinical diagnosis is challenging due to its heterogeneous presentation, which typically follows an insidious course and lacks systemic inflammatory response signs. We present the case of a 46-year-old woman who presented with a 3-month history of suboccipital headache, accompanied by gait ataxia and dizziness for 7 days. Neurological examination revealed upbeat nystagmus in the right eye, dysarthria, right-sided dysmetria, and lateropulsion. Magnetic resonance imaging revealed an irregular, multiloculated, ring-enhancing cystic lesion in the right cerebellar hemisphere with evidence of restricted diffusion. The abscess was drained via stereotactic navigation, and culture identified Nocardia cyriacigeorgica. Targeted antibiotic therapy was initiated according to sensitivity testing, resulting in marked clinical improvement and resolution of the patient's cerebellar symptoms. This case presents an isolated cerebellar abscess caused by N. cyriacigeorgica in an immunocompetent patient, highlighting the diagnostic and therapeutic challenges involved.

Keywords

cerebellar abscess - brain abscess - immunocompetent - Nocardia - Nocardia cyriacigeorgica

Patients' Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published, and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.




Publication History

Article published online:
09 December 2025

© 2025. Asian Congress of Neurological Surgeons. 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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