title: [Recurrent brain abscess caused by Nocardia asteroides in a patient with primary polycythaemia].
abstract: Nocardiosis of the central nervous system (CNS) is an uncommon disease, but its frequency has increased due to the high number of immunosuppressive treatments. People become infected by inhalation, direct traumatic cutaneous inoculation and eating contaminated food after a periodontal abscess. Lung localization is the most frequent one, being the origin of haematic dissemination, with a high incidence in skin, subcutaneous tissue and the CNS. The preference of Nocardia for the CNS is well-known. These abscesses are a diagnostic and therapeutic challenge, since they are associated to high mortality rates, specially in immunocompromised patients; the best therapeutic management remains unclear. In spite of the existing controversy with regard to the surgical management of these lesions, an early diagnosis through stereotactic aspiration and the beginning of an antimicrobial therapy are essential to the patients good evolution. This paper presents a patient with a primary polycythaemia and a recurrent brain abscess by Nocardia asteroides, probably of dental origin.
authors.affiliation: Instituto de Neurología, Facultad de Medicina, Hospital de Clinicas Dr. Manual Quintela, Avenida Italia s/n, Montevideo 11600, Uruguay. caboal@gmail.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Aboal
authors.forename: Ronald
authors.initials: R
authors.lastname: Salamano
authors.forename: Adelina
authors.initials: A
authors.lastname: Braselli
authors.forename: Mariel
authors.initials: M
authors.lastname: Mansilla
authors.forename: Maria
authors.initials: M
authors.lastname: Galaret
authors.forename: Walter
authors.initials: W
authors.lastname: Pedreira
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003757:Dental Implantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009617:Nocardia Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D009616:Nocardia asteroides; D011087:Polycythemia Vera / Q000150:complications*; D012008:Recurrence