Nocardia farcinica as a cause of chronic meningitis - case report

• Published in: BMC infectious diseases 2020-01, Vol.20 (1), p.56-56, Article 56
• Main Authors: Moniuszko-Malinowska, Anna, Czupryna, Piotr, Swiecicka, Izabela, Grześ, Henryk, Siemieniako, Agnieszka, Grygorczuk, Sambor, Tarasów, Eugeniusz, Pancewicz, Sławomir
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteria; Brain - diagnostic imaging; Care and treatment; Case Report; Case reports; Case studies; Causes of; Cerebrospinal fluid; Chalk; Chronic Disease; Chronic infection; Cysts; Cytomegalovirus; Dentists; Deoxyribonucleic acid; Diagnostic systems; Diseases; DNA; DNA, Bacterial - genetics; DNA, Bacterial - metabolism; Fever; Gram-positive bacteria; Headaches; Health aspects; Herpes viruses; Hospitals; Humans; Immunocompromised Host; Immunocompromised hosts; Infectious diseases; Kocuria; Magnetic Resonance Imaging; Meningitis; Meningitis - diagnosis; Meningitis - drug therapy; Meningitis - microbiology; Meropenem; Middle Aged; Mining industry; Nervous system; Nocardia; Nocardia - genetics; Nocardia - isolation & purification; Nocardia farcinica; Nocardiosis; Opportunist infection; Pathogens; Patients; Recovery; Streptococcus infections
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-4764-y

Nocardiosis is an uncommon disease caused by aerobic gram-positive bacteria Nocardia spp. Although it is usually an opportunistic infection affecting immunocompromised patients, even one third of cases occur in immunocompetent persons. The aim of the study was to describe the course of chronic meningitis due to Nocardia infection. A 52-year-old patient, chalk miner, suffered from a chronic meningitis caused by an extremely rare pathogen. The patient's history was complicated and diagnostic process covered multiple examinations and consultations. Initially Kocuria rosea was cultured, yet after molecular examination the result was verified to Nocardia farcinica. Targeted antibiotic treatment was implemented, which resulted in gradual improvement of patients condition. A full recovery was achieved after one year antibiotic therapy. 1.Nocardia farcinica is an uncommon but possible cause of chronic meningitis.2.In the case of a chronic meningitis of unknown origin multiple cerebrospinal fluid cultures should be performed as the identification of pathogen may be crucial for patient's recovery.3.In case of unusual culture, such as Kocuria spp. PCR should be performed.