Nocardial brain abscess: observation of treatment strategies and outcome in Switzerland from 1992 to 1999.
BACKGROUND
Brain abscesses caused by Nocardia spp. are rare, but life-threatening infections that are notoriously difficult to diagnose and treat and which occur mainly in immunocompromised patients. Standard treatment guidelines are not available.


METHODS
A systematic search for nocardial brain abscesses from 1992 to 1999 was conducted in Switzerland for the comparison of clinical presentation, treatment strategies and outcome.


RESULTS
Seven cases were found, for which data of six were available. In 4/6 patients antimicrobial therapy led to a decrease in the size of abscesses. Four of six patients died. The cause of death was likely due to underlying co-morbidities, rather than the nocardial infection.


CONCLUSIONS
The finding that treatment was different in each case underscores the lack of therapeutic guidelines.
Loeffler
J M
JM
Institute for Infectious Diseases, University of Bern, Switzerland.
Bodmer
T
T
Zimmerli
W
W
Leib
S L
SL
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001922:Brain Abscess / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents