Resolution of innumerable cerebral Nocardia paucivorans abscesses after medical management. (May 2016)

• Record Type: Journal Article
• Authors: Delavari, Nader; Than, Khoi D.; Chen, Kevin S.; McKeever, Paul E.; Wang, Anthony C.; Pandey, Aditya S.
• Is Part Of: Journal of clinical neuroscience. Volume 27(2016:May)
• Page Start: 175
• Page End: 177
• Publication Date: 2016-05
• Subjects: Brain abscess -- Nocardia paucivorans -- Nocardiosis; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2015.10.028
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Sensitivity of Nocardia abscesses to most antibiotics may explain clinical/radiographic improvements. Use of polymerase chain reaction techniques helps establish a timely diagnosis. Steroids should be tapered slowly to minimize cerebral inflammation. Abstract: Nocardia species are an infrequent cause of brain abscesses. We report a 50-year-old man with Nocardia paucivorans cerebral abscesses. Brain MRI revealed innumerable small ring-enhancing lesions. The patient initially responded to treatment with antibiotics and steroids, but experienced worsening after discontinuation of steroids. Brain biopsy performed to exclude central nervous system lymphoma produced nodular tissue with branching filaments on silver stain. Steroids were re-initiated and tapered slowly. The patient completed 1 year of antibiotic therapy, after which he had no neurological symptoms and complete resolution of all brain abscesses on MRI.