Nocardia farcinicaabscess of the cerebellum in an immunocompetent patient: A case report and review of the literature.
Nocardial brain abscesses are uncommon and rarely occur in patients without predisposing factors. They may be mistaken for gliomas or necrotic metastases, and surgical intervention may be required to make the diagnosis. We report the first case ofNocardia farcinicacerebellar abscess in a patient without immunosuppression. He presented to us with headache and instability beginning a week before. Brain magnetic resonance imaging (MRI) revealed a cystic lesion located at the right cerebellar hemisphere, hypointense in T1 and hyperintense in T2, with a fine wall that enhanced after injection of gadolinium. Image tests also showed a cavitated lesion at the upper lobule of the right lung. The patient underwent craniotomy and drainage of the cerebellar abscess. Initial post-operative treatment with linezolid produced a limited response. He was re-operated and vancomycin, imipenem and ciprofloxacin were added with an excellent outcome of the cerebellar and lung lesions.
Department of Neurosurgery, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
María
M
Pascual-Gallego
Department of Neurosurgery, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
Pedro
P
Alonso-Lera
Department of Microbiology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
Ana
A
Arribi
Department of Neurosurgery, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
Juan A
JA
Barcia
Department of Internal Medicine, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
Javier
J
Marco
Cerebellar abscess; immunocompetent; nocardia
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