Brain Absceses Caused by Nocardia – Two Case Reports

Authors: S. Plíšek 1;  K. Honegr 1;  J. Kapla 1;  J. Scharfen Jr 2,6;  P. Prášil 1;  P. Kosina 1;  V. Hobza 3;  R. Taláb 4;  P. Eliáš 5;  P. Ryška 5;  M. Morávková 6;  L. Plíšková 7;  M. Bunček 8;  M. Fridrichová 9
Authors‘ workplace: Klinika infekčních nemocí LF UK a FN Hradec Králové 1;  Národní referenční laboratoř pro patogenní aktinomycety, Oblastní nemocnice Trutnov a. s. 2;  Neurochirurgická klinika LF UK a FN Hradec Králové 3;  Neurologická klinika LF UK a FN Hradec Králové 4;  Radiologická klinika LF UK a FN Hradec Králové 5;  Ústav klinické mikrobiologieLF UK a FN Hradec Králové 6;  Ústav klinické biochemie a diagnostiky LF UK a FN Hradec Králové 7;  Generi Biotech s. r. o., Hradec Králové 8;  Národní referenční laboratoř pro antibiotika, Státní zdravotní ústav Praha 9
Published in: Cesk Slov Neurol N 2011; 74/107(1): 78-82
Category: Case Report


The recorded incidence of human infections caused by Nocardia spp. has increased over the past 20 years, both in response to improved diagnostic techniques and to rising numbers of immunocompromised patients. Nocardial infections primarily affect the skin and lungs, but the bacteria may disseminate to any organ, including the brain. The diagnosis and treatment of patients suffering from a Nocardia infection require an interdisciplinary approach. Here we describe two case reports of patients suffering from brain abscesses caused by Nocardia that required neurosurgical treatment.

Key words:
brain abscess – Nocardia farcinica – treatment – antibiotics – brain tumour


1. Scharfen J jr. Nokardióza. 1st ed. Hradec Králové: Nucleus 2008.

2. Holčíková A. Nokardióza. In: Beneš J (ed). Infekční lékařství. 1st ed. Praha: Galén 2009.

3. Scharfen J jr, Plíšek S, Fridrichová M, Urbášková P, Morávková M, Hobza V et al. Nocardia farcinica z abscesu mozku u imunosuprimovaného pacienta. Zprávy EM (SZÚ, Praha) 2009; 18(5): 172–174.

4. Yamada SM, Nakai E, Toyonaga S, Nakabayashi H, Park KC, Shimizu K. A rapidly enlarging nocardial brain abscess mimicking malignant glioma. J Nippon Med Sch 2005; 72(5): 308–311.

5. Mandell D, Bennett JE. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone 2009.

6. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ jr. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 2006; 19(2): 259–282.

7. Lerner PI. Nocardiosis. Clin Infect Dis 1996; 22(6): 891–905.

8. Peleg AY, Husain S, Qureshi ZA, Silveira FP, Sarumi M, Shutt KA et al. Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study. Clin Infect Dis 2007; 44(10): 1307–1314.

9. Beaman BL, Beaman L. Nocardia species: host-parasite relationships. Clin Microbiol Rev 1994; 7(2): 213–264.

10. Tamplin ML, McClung NM. Quantitative studies of the relationship between trehalose lipids and virulence of Nocardia asteroides isolates. In: Ortiz-Ortiz L, Bojalil LF, Yakeloff V (eds). Biological, biochemical and biomedical aspects of actinomycetes, Orlando: Academic Press 1984: 251–258.

11. Javaly K, Horowitz HW, Wormser GP. Nocardiosis in patients with human immunodeficiency virus infection. Report of 2 cases and review of the literature. Medicine (Baltimore) 1992; 71(3): 128–138.

12. Boiron P, Provost F, Chevrier G, Dupont B. Review of nocardial infections in France 1987 to 1990. Eur J Clin Microbiol Infect Dis 1992; 11(8): 709–714.

13. Georghiou PR, Blacklock ZM. Infection with Nocardia species in Queensland: a review of 102 clinical isolates. Med J Aust 1992; 156(10): 692–697.

14. Smego RA jr, Moeller MB, Gallis HA. Trimethoprim-sulfamethoxazole therapy for Nocardia infections. Arch Intern Med 1983; 143(4): 711–718.

15. Beaman BL, Boiron P, Beaman L, Brownell GH, Schaal K, Gombert ME. Nocardia and nocardiosis. J Med Vet Mycol 1992; 30 (Suppl 1): 317–331.

16. Bach MC, Monaco AP, Finland M. Pulmonary nocardiosis. Therapy with minocycline and with erythromycin plus ampicillin. JAMA 1973; 224(10): 1378–1381.

17. Jodlowski TZ, Melnychuk I, Conry J. Linezolid for the treatment of Nocardia spp. infections. Ann Pharmacother 2007; 41(10): 1694–1699.

18. Mamelak AN, Obana WG, Flaherty JF, Rosenblum ML. Nocardial brain abscess: treatment strategies and factors influencing outcome. Neurosurgery 1994; 35(4): 622–631.

19. Scharfen J jr, Scharfen J, Harmsen D, Bunček M. Doporučená metoda k předběžné identifikaci nokardií podle fenotypu rezistence. Zprávy CEM (SZÚ, Praha) 2007; 16(3): 131–136.

20. Viechová J, Beneš J, Kabelková M, Gabrielová A. Nokardióza. Prakt Lék 2003; 83(7): 382–385.

21. Nyč O, Lochmann O, Lomíček M, Merhaut T. Izolace Nocardia asteroides z hemokultury. Cs Epidem 1992; 41(5): 281–284.

Paediatric neurology Neurosurgery Neurology

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