Karan Mladen, Vučković Nada, Vuleković Petar, Rotim Ante, Lasica Nebojša, Rasulić Lukas
1Department of Surgery, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2Department of Pathology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Pathology and Histology Center, Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia; 6Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 7Department of Neurosurgery, Clinical Centre of Serbia, Belgrade, Serbia.
Acta Clin Croat. 2019 Sep;58(3):540-545. doi: 10.20471/acc.2019.58.03.20.
Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. Immunocompetent and immunocompromised patients both can be affected and was reported as a pathogen isolated in patients worldwide. In most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise awareness of the possibility for this rare but potentially fatal condition. We present a case where nocardial abscesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome.
诺卡菌是一种普遍存在的微生物，可导致人类局部和播散性感染。免疫功能正常和免疫功能低下的患者均可受到影响，并且在世界各地的患者中均有作为病原体分离出来的报道。在大多数情况下，诺卡菌病表现为肺部感染，因为吸入是细菌暴露的主要途径。诺卡菌性脑脓肿通常继发于身体其他部位的脓毒症病灶。鉴于老年人口不断增加，免疫功能低下患者的数量也在增加，以及中枢神经系统诺卡菌感染患者的高死亡率，我们必须提高对这种罕见但可能致命疾病的认识。我们报告一例最初被怀疑为肺癌伴脑转移的肺和脑诺卡菌脓肿病例。该患者接受了手术切除和抗菌治疗相结合的治疗，效果良好。
