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

Theodora Anagnostou, Marios Arvanitis, Themistoklis K. Kourkoumpetis, Athanasios Desalermos, Herman A. Carneiro, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

127 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)19-32
Number of pages14
JournalMedicine (United States)
Volume93
Issue number1
DOIs
StatePublished - Jan 2014

ASJC Scopus subject areas

  • Medicine(all)

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