title: Nocardia farcinica brain abscess: epidemiology, pathophysiology, and literature review.
abstract: BACKGROUND
  Infections caused by Nocardia farcinica are potentially lethal because of the organism's tendency to disseminate and resist antibiotics. Central nervous system involvement has been documented in 30% of infections caused N. farcinica.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A case of primary brain abscess caused by N. farcinica, identified by 16SrRNA sequencing, is presented, and 39 cases reported previously in the literature are reviewed. Our patient underwent a neuronavigation-guided right frontal craniotomy and was treated with trimethoprim/sulfamethoxazole and amoxicillin-clavulanic acid for 12 mo. He showed marginal improvement in his prior left hemiparesis at the last review 14 months later.
  
  
  CONCLUSIONS
  Cases of N. farcinica infections are being reported increasingly because of recent changes in taxonomy and diagnostic methodology. This change in epidemiology has implications for therapy because of the organism's pathogenicity and natural resistance to multiple antimicrobial agents, including third-generation cephalosporins. Any delay in starting appropriate antibiotic therapy can have adverse consequences.
authors.affiliation: 1 Department of Microbiology, Amrita Institute of Medical Sciences , Kerala, India .
authors.forename: V Anil
authors.initials: VA
authors.lastname: Kumar
authors.forename: Deepthi
authors.initials: D
authors.lastname: Augustine
authors.forename: Dilip
authors.initials: D
authors.lastname: Panikar
authors.forename: Aswathy
authors.initials: A
authors.lastname: Nandakumar
authors.forename: Kavitha R
authors.initials: KR
authors.lastname: Dinesh
authors.forename: Shamsul
authors.initials: S
authors.lastname: Karim
authors.forename: Rosamma
authors.initials: R
authors.lastname: Philip
mesh_terms: D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000473:pathology*; D055815:Young Adult