Srivastava Sonakshi, Kanaujia Rimjhim, Sahoo Sushant Kumar, Jani Parth, Angrup Archana, Rudramurthy Shivaprakash M, Ray Pallab
Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Family Med Prim Care. 2020 Feb 28;9(2):1232-1235. doi: 10.4103/jfmpc.jfmpc_1005_19. eCollection 2020 Feb.
Human nocardiosis is primarily an opportunistic infection affecting immunocompromised patients, however, one-third of them are immunocompetent. CNS involvement is less commonly reported and associated with a grave prognosis. The majority of these patients are organ transplant recipients on immune suppressants. In the recent past, association of with brain abscess has been reported in a few cases. We are reporting a case of isolated cerebellar abscess caused by in an immune-compromised adult with a review of relevant literature. A 53-year-old male presented with complaints of headache and vomiting for 14 days. There was no previous history of any comorbid illness. During presentation, he was having gait ataxia and radiology showed the right-sided cerebellar multiple lesions. Further hematological investigations revealed the patient to be HIV positive. The abscess was tapped and the pus culture showed Nocardia species. Antibiotics were started as per sensitivity and the patient did well at 3-month follow-up. Though rare, Nocardia should be kept as a differential in brain abscess patients. Owing to the different antimicrobial sensitivity patterns among species, both appropriate speciation and susceptibility testing of uncommon species such as are required for their successful treatment.
人类诺卡菌病主要是一种影响免疫功能低下患者的机会性感染，然而，其中三分之一的患者免疫功能正常。中枢神经系统受累的报道较少，且预后严重。这些患者大多数是接受免疫抑制剂治疗的器官移植受者。最近，有少数病例报道了[原文此处缺失相关内容]与脑脓肿的关联。我们报告一例免疫功能低下的成年人因[原文此处缺失相关内容]导致孤立性小脑脓肿的病例，并对相关文献进行综述。一名53岁男性因头痛和呕吐14天就诊。既往无任何合并症病史。就诊时，他有步态共济失调，影像学显示右侧小脑多发病变。进一步的血液学检查显示该患者HIV阳性。脓肿穿刺引流，脓液培养显示为诺卡菌属。根据药敏结果开始使用抗生素，患者在3个月的随访中情况良好。尽管罕见，但在脑脓肿患者中应将诺卡菌作为鉴别诊断之一。由于诺卡菌属菌种之间抗菌敏感性模式不同，对于[原文此处缺失相关内容]等不常见菌种，成功治疗需要进行适当的菌种鉴定和药敏试验。
