Nocardia araoensis causing brain abscess

Nocardial brain abscess is a rare central nervous system infection with high morbidity and mortality. Most of the human infections, i.e., about 90%, are due to Nocardia asteroides group comprising N. asteroides complex, Nocardia farcinica, and Nocardia nova. Other species rarely cause human infectio...

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Bibliographic Details
Published in:Asian journal of neurosurgery 2019-07, Vol.14 (3), p.952-956
Main Authors: Joshua, Shejoy, Babu, Rachana, Warrier, Anup, Panikar, Dilip
Format: Article
Language:English
Subjects:
Anemia
Brain abscess
Care and treatment
Case Report
Central nervous system
Corticosteroid drugs
Diabetes mellitus
Diagnosis
Glucocorticoids
Health aspects
Hemolytic anemia
Imipenem
Infection
Meropenem
Morbidity
Mortality
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Summary:Nocardial brain abscess is a rare central nervous system infection with high morbidity and mortality. Most of the human infections, i.e., about 90%, are due to Nocardia asteroides group comprising N. asteroides complex, Nocardia farcinica, and Nocardia nova. Other species rarely cause human infections. Here, we report a case of left parieto-occipital abscess caused by a rare species, Nocardia araoensis, its diagnosis, treatment options, and review of literature. A 73-year-old male, known case of diabetes mellitus, on prolonged oral corticosteroid for autoimmune hemolytic anemia presented with a 1-month history of memory deficit and gait imbalance. On examination, he had a right inferior quadrantanopia and hemiparesis. Magnetic resonance imaging showed a multiloculated ring-enhancing lesion in the left parieto-occipital region. Navigation-assisted biopsy was done. The organism isolated was N. araoensis. He was treated successfully with prolonged course of antibiotics which resulted in complete clinical and radiological resolution. N. araoensis is a rare cause of brain abscess and needs to be suspected in immunocompromised individuals. Early diagnosis and prolonged treatment can result in complete clinical and radiological resolution.
ISSN:1793-5482
2248-9614
DOI:10.4103/ajns.AJNS_66_19