Multiple rim-enhancing brain lesions and pulmonary cavitary nodules as the presentation of Nocardia cyriacigeorgica in a patient with non–small cell lung cancer

Nocardiosis is caused by various strains of the genus Nocardia, a gram-positive, acid-fast bacillus found in organic matter. Disseminated nocardiosis with central nervous system involvement is a rare infection that is most commonly seen in immunocompromised patients. We present a case of a 67-year-o...

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Bibliographic Details
Published in:Proceedings - Baylor University. Medical Center 2022-07, Vol.35 (4), p.555-556
Main Authors: Bejcek, Alexis, Owens, Justin, Marella, Aditi, George, Aneesh
Format: Article
Language:English
Subjects:
Case Report
Case Studies
Gram-positive bacteria
Lung cancer
Nervous system
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Summary:Nocardiosis is caused by various strains of the genus Nocardia, a gram-positive, acid-fast bacillus found in organic matter. Disseminated nocardiosis with central nervous system involvement is a rare infection that is most commonly seen in immunocompromised patients. We present a case of a 67-year-old veteran with stage IV adenocarcinoma of the lung undergoing chemotherapy who presented with new cavitary pulmonary lesions. Three weeks into his hospitalization, a sputum culture with acid-fast staining returned positive for Nocardia cyriacigeorgica. A subsequent computed tomography scan of the head demonstrated numerous rim-enhancing lesions presumed to be due to disseminated nocardiosis with central nervous system involvement. Disseminated nocardiosis has a high mortality rate, making prompt detection and treatment paramount for these patients. Our case highlights the importance of considering central nervous system involvement in the evaluation of a patient with nocardiosis.
ISSN:0899-8280
1525-3252
DOI:10.1080/08998280.2022.2058831