Molecular diagnosis of Nocardia farcinica from a cerebral abscess

• Published in: Human pathology 2006-08, Vol.37 (8), p.1117-1121
• Main Authors: Tatti, Kathleen M., Shieh, Wun-Ju, Phillips, Sonya, Augenbraun, Michael, Rao, Chandrakant, Zaki, Sherif R.
• Format: Article
• Language: English
• Subjects: 16S rDNA; Adult; Bacterial infections; Biological and medical sciences; Biopsy; Blood; Brain - microbiology; Brain - pathology; Brain Abscess - drug therapy; Brain Abscess - microbiology; Brain Abscess - pathology; Cerebral abscess; DNA, Bacterial - analysis; DNA, Bacterial - genetics; DNA, Ribosomal - analysis; Hospitalization; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Microbiology; Mortality; Nocardia - genetics; Nocardia - isolation & purification; Nocardia farcinica; Nocardia Infections - drug therapy; Nocardia Infections - microbiology; Nocardia Infections - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; PCR; Polymerase Chain Reaction; Ribosomal DNA; RNA, Ribosomal, 16S - analysis; RNA, Ribosomal, 16S - genetics; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2006.02.019

Histopathology and special stains of a brain biopsy specimen from a 42-year-old man revealed numerous gram-positive bacilli arranged in branching filaments, suggesting Nocardia infection. Antibiotic therapy with trimethoprim-sulfamethoxazole markedly decreased the abscess size, and the patient improved. DNA was analyzed from formalin-fixed sections of the cerebral abscess by a 16S ribosomal DNA polymerase chain reaction assay demonstrating the presence of either Nocardia farcinica or N otitidiscaviarum. A species-specific polymerase chain reaction assay confirmed N farcinica as the etiologic agent.