Nocardiosis of the central nervous system: experience from a general hospital and review of 84 cases from the literature.

Abstract:

:Central nervous system (CNS) nocardiosis is a rare disease entity caused by the filamentous bacteria Nocardia species. We present a case series of 5 patients from our hospital and a review of the cases of CNS nocardiosis reported in the literature from January 2000 to December 2011. Our results indicate that CNS nocardiosis can occur in both immunocompromised and immunocompetent individuals and can be the result of prior pulmonary infection or can exist on its own. The most common predisposing factors are corticosteroid use (54% of patients) and organ transplantation (25%). Presentation of the disease is widely variable, and available diagnostic tests are far from perfect, often leading to delayed detection and initiation of treatment. The optimal therapeutic approach is still undetermined and depends on speciation, but lower mortality and relapse rates have been reported with a combination of targeted antimicrobial treatment including trimethoprim/sulfomethoxazole (TMP-SMX) for more than 6 months and neurosurgical intervention.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Anagnostou T,Arvanitis M,Kourkoumpetis TK,Desalermos A,Carneiro HA,Mylonakis E

doi

10.1097/MD.0000000000000012

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

19-32

issue

1

eissn

0025-7974

issn

1536-5964

pii

00005792-201401000-00003

journal_volume

93

pub_type

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