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免疫功能正常患者中与肺栓塞相关的鼻疽诺卡菌脑脓肿

[Nocardia farcinica brain abscess associated with a pulmonary embolism in an immunocompetent patient].

作者信息

Djennane Sabria, Zecknini Khalid, Billy Christophe, Kamga Isabelle, Perronne Véronique, Granier Françoise

机构信息

Service de médecine interne-maladies infectieuses et tropicales, CHF Quesnay, Mantes la Jolie.

出版信息

Presse Med. 2005 Apr 9;34(7):522-4. doi: 10.1016/s0755-4982(05)83964-8.

Abstract

INTRODUCTION

Nocardiosis is a rare, generally systemic infection that occurs in immunocompromised patients. We report a case of Nocardia farcinica primary brain abscess in an immunocompetent patient, unusually associated with a pulmonary embolism.

OBSERVATION

A 62 year-old woman without medical past was hospitalised because of a Bravais-Jacksonian type of seizure. The clinical and radiological profile was unspecific. The diagnosis was made on identification of the microorganism. The patient improved after craniotomy with excision of the abscess and appropriate antibiotic therapy for four months.

DISCUSSION

The N. farcinica species is distinct from others by its high degree of antibiotic resistance its virulence. We insist on the need to identify not only the microorganism but also the species concerned because this may influence the treatment strategy.

摘要

引言

诺卡菌病是一种罕见的、通常发生在免疫功能低下患者中的全身性感染。我们报告一例免疫功能正常的患者发生豚鼠耳炎诺卡菌原发性脑脓肿,且异常地合并肺栓塞。

病例报告

一名无既往病史的62岁女性因杰克逊癫痫发作入院。临床和影像学表现无特异性。通过微生物鉴定做出诊断。患者在开颅切除脓肿并进行四个月的适当抗生素治疗后病情好转。

讨论

豚鼠耳炎诺卡菌因其高度的抗生素耐药性和毒力而与其他菌种不同。我们强调不仅要鉴定微生物,还要鉴定相关菌种,因为这可能会影响治疗策略。

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