title: Primary Nocardia meningitis in a patient without a predisposing condition: case report and review of the literature.
abstract: A case of primary Nocardia meningitis in a patient without a predisposing condition is presented and 4 other reported cases are reviewed. The presenting features were fever, headache, altered consciousness, and neck stiffness. Cerebrospinal fluid examination (CSF) revealed hypoglycorrhachia (<40 mg/dl), elevated protein (>100 mg/dl), and pleocytosis with predominant neutrophils in all patients. Culture of CSF was positive for Nocardia in 4 of the 5 patients. Mortality was 50%. Diagnosis was frequently delayed and this probably contributed to the high mortality. Compared with Nocardia meningitis in association with a predisposing condition, primary Nocardia meningitis without a predisposing condition has similar clinical features and outcome.
authors.affiliation: Department of Internal Medicine, Hamad Medical Corporation, Doha-Qatar. hussamalsoub@yahoo.com
authors.forename: Hussam
authors.initials: H
authors.lastname: Al Soub
authors.forename: Mona
authors.initials: M
authors.lastname: Almaslamani
authors.forename: Jameela
authors.initials: J
authors.lastname: Al Khuwaiter
authors.forename: Yasser
authors.initials: Y
authors.lastname: El Deeb
authors.forename: Mohammed Abu
authors.initials: MA
authors.lastname: Khatab
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D008875:Middle Aged; D009617:Nocardia Infections / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000188:drug therapy; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination