Nocardial brain abscess: Review of clinical management


KILINÇER C., Hamamcioglu M. K., ŞİMŞEK O., HİÇDÖNMEZ T., AYDOSLU B., Tansel O., ...Daha Fazla

Journal of Clinical Neuroscience, cilt.13, sa.4, ss.481-485, 2006 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 4
  • Basım Tarihi: 2006
  • Doi Numarası: 10.1016/j.jocn.2005.04.031
  • Dergi Adı: Journal of Clinical Neuroscience
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.481-485
  • Anahtar Kelimeler: Brain abscess, Immunosuppression, Minocycline, Nocardia infection, Opportunistic infection, Trimethoprim-sulfamethoxazole combination
  • Trakya Üniversitesi Adresli: Evet

Özet

Nocardiosis has become a significant opportunistic infection over the last two decades as the number of immunocompromised individuals has grown worldwide. We present two patients with nocardial brain abscess. The first patient was a 39-year-old woman with systemic lupus erythematosus. A left temporoparietal abscess was detected and aspirated through a burr-hole. Nocardia farcinica infection was diagnosed. The patient had an accompanying pulmonary infection and was thus treated with imipenem and amikacine for 3 weeks. She received oral minocycline for 1 year. The second patient was a 43-year-old man who was being treated with corticosteroids for glomerulonephritis. He was diagnosed with a ring-enhancing multiloculated abscess in the left cerebellar hemisphere, with an additional two small supratentorial lesions and triventricular hydrocephalus. Gross total excision of the cerebellar abscess was performed via a left suboccipital craniectomy. Culture revealed Nocardia asteroides, and the patient was successfully treated with intravenous ceftriaxone, then oral trimethoprime-sulfamethoxazole for 1 year. The clinical course, radiological findings, and management of nocardial brain abscess are discussed in light of the relevant literature, and current clinical management is reviewed through examination of the cases presented here. © 2006 Elsevier Ltd. All rights reserved.