Nocardia exalbida brain abscess in a patient with follicular lymphoma.
Nocardial brain abscess is a rare but severe complication in patients with malignancy. Nocardia exalbida was isolated in Japan and characterized within the genus Nocardia. We present the first report of N. exalbida brain abscess in a 63-year-old male patient with follicular lymphoma. He developed abnormal neurological findings during follicular lymphoma treatment, brain CT revealed ring-enhancing, multiloculated lesions, and N. exalbida was detected by aspiration of the lesion. He was successfully treated with trimethoprime-sulfamethoxazole (TMP-SMX) and meropenem without craniotomy or repeat aspirations. It should be noted that such an infection can occur in patients treated with conventional chemotherapy against malignant lymphoma.
Ono
Makiko
M
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Kobayashi
Yukio
Y
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan. ykkobaya@ncc.go.jp.
Shibata
Tsuyoshi
T
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Maruyama
Dai
D
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Kim
Sung-Won
SW
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Watanabe
Takashi
T
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Mikami
Yuzuru
Y
Medical Mycology Research Center (MMRC), Chiba University, Chiba, Japan.
Tobinai
Kensei
K
Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001922:Brain Abscess / Q000139:chemically induced / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009615:Nocardia; D009617:Nocardia Infections / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone