title: Successful treatment of multifoci nocardial brain abscesses: a case report and literature review.
abstract: Brain nocardiosis is a serious opportunistic infection with high mortality. It exists more common in the immunocompromised hosts than the immunocompetent patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) has been mostly considered as the choice of the medical treatment. Linezolid is also newly found to be effective to avoid the invasive surgery. The authors reported a case of patient with multifoci nocardial brain abscesses who failed with the combination of linezolid and TMP-SMZ alone but recovered with the surgery intervention and sequential antibiotics for 2 years. The patient lived a high quality life without recurrence and complications during the 30 months follow-up.Through the literature review, we recommend earlier stereotactic aspiration for diagnosis, combination with surgery intervention and prolonged anti-infection therapy would improve the prognosis.
authors.affiliation: From Department of Neurosurgery, The First Affiliated Hospital (QX, RZ, YF); State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University (JC); and Collaborateive Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China (JC).
authors.forename: Qingsheng
authors.initials: Q
authors.lastname: Xu
authors.forename: Renya
authors.initials: R
authors.lastname: Zhan
authors.forename: Yiping
authors.initials: Y
authors.lastname: Feng
authors.forename: Jiajia
authors.initials: J
authors.lastname: Chen
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D002438:Cefoperazone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D016867:Immunocompromised Host; D000069349:Linezolid; D008297:Male; D009617:Nocardia Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D009894:Opportunistic Infections / Q000188:drug therapy*; D023303:Oxazolidinones / Q000627:therapeutic use; D013407:Sulbactam / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D002438:Cefoperazone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000069349:Linezolid; D013407:Sulbactam