Larrañaga Lapique Eva, Gallemaers Salomé, Schuind Sophie, Mabiglia Chiara, Yin Nicolas, Martiny Delphine, Hites Maya
Departement Clinic of Infectious Diseases, Hôpital Universitaire de Bruxelles (HUB)-Erasme, 1070 Brussels, Belgium.
Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitaire Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), 1000 Brussels, Belgium.
Microorganisms. 2025 Jun 30;13(7):1536. doi: 10.3390/microorganisms13071536.
spp. is an environmental Gram-positive bacterium able to cause infections in humans, predominantly of an opportunistic nature. Nocardial brain abscesses are rare and result from dissemination from another primary lesion, mainly observed in immunocompromised hosts. The diagnosis of nocardiosis relies on direct examination and bacterial culture, but antimicrobial susceptibility testing (AST) remains controversial due to technical challenges, limited standardization, and a paucity of studies correlating in vitro susceptibility with clinical efficacy. Management is challenging and usually based on expert opinion, as robust evidence is limited. In this case report, we describe an immunocompromised patient with a brain abscess who achieved clinical resolution following combination therapy that included ceftriaxone, despite in vitro resistance, illustrating the complexities in interpreting AST and guiding treatment decisions in rare infections.
诺卡菌属是一种环境革兰氏阳性菌，能够引起人类感染，主要为机会性感染。诺卡菌性脑脓肿罕见，是由另一个原发性病灶播散所致，主要见于免疫功能低下的宿主。诺卡菌病的诊断依赖于直接检查和细菌培养，但由于技术挑战、标准化有限以及将体外药敏与临床疗效相关联的研究匮乏，抗菌药物敏感性试验（AST）仍存在争议。治疗具有挑战性，通常基于专家意见，因为有力的证据有限。在本病例报告中，我们描述了一名患有脑脓肿的免疫功能低下患者，尽管体外耐药，但在接受包括头孢曲松在内的联合治疗后实现了临床缓解，这说明了在罕见感染中解读AST和指导治疗决策的复杂性。
