Diagnosis and Neurosurgical Management of Cerebral Nocardiosis

Carley Karam; Abdolreza Siadati

doi:10.1055/s-0040-1722345

Journal of Neurological Surgery Reports, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neurol Surg Rep 2021; 82(02): e21-e24
DOI: 10.1055/s-0040-1722345

Case Report

Diagnosis and Neurosurgical Management of Cerebral Nocardiosis

Authors

Carley Karam

¹Department of Surgery, Neurosurgery Clinical Clerkship, University of North Texas Health Science Center, Medical City Hospital, Fort Worth, Texas, United States
Abdolreza Siadati

¹Department of Surgery, Neurosurgery Clinical Clerkship, University of North Texas Health Science Center, Medical City Hospital, Fort Worth, Texas, United States

Abstract

Primary Nocardia infections are uncommon gram-positive bacterial infections caused by aerobic actinomycetes and are typically regarded as opportunistic infections (only one-third of infected patients are immunocompetent). Risk factors include: glucocorticoid therapy, malignancy, organ transplant recipients, human immunodeficiency virus infections, tumor necrosis factor-α inhibitor therapy, diabetes mellitus, alcoholism, inflammatory bowel disease, chronic obstructive pulmonary disease, chronic granulomatous disease, and tuberculosis. The organism has a predisposition to disseminate to the central nervous system and can relapse or progress despite appropriate therapy. Treatment ranges from oral antibiotic management to multiple intravenous antibiotic therapy, with surgical intervention required for severe cases. The surgical options include aspiration or complete excision of abscess contents and capsule. In the present case, we describe the use of bilateral craniotomy with assisted image guidance and multiple abscess excision in an immunocompetent patient with systemic nocardiosis.

Keywords

Nocardia - abscess - craniotomy - excision - infection - complete - surgical - tuberculosis

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Referenzen

References
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