Nocardia brain abscess - case report and literature review

Abstract

Background and purposeNocardia species is an aerobic soil-saprophyte bacterium, responsible for rare opportunistic infections, mainly reported in immunocompromised patients. Nocardia brain abscess accounts for 1 to 2% of cerebral abscess. Abscesses are mainly located in the brain stem. Prognosis is poor.
Methods The authors report one biloculated cerebral abscess case located in the left cerebellar and occipital lobes. We describe clinical, radiological and bacteriological findings and management; we also a review literature on Nocardia cerebral abscess.
Case report A 56 year old man who was immunosuppressed, presented with headache and cerebellar syndrome. Head Computerised Tomography showed an irregularly enhancing cystic lesion in the left cerebellar and occipital lobes. He underwent posterior fossa cranitomy and chemotherapy that included high doses of Sulfamethoxazole-Trimethoprim and cefotaxime as microbateriologic examination revealed norcardia asteroids. He was eventually discharged home.
Conclusion Nocardiasis is a rare cause of cerebral abcess in Morocco. Effective management includes early surgery and treatment with appropriate antibiotics.