Nocardiosis (central nervous system manifestations)

Central nervous system (CNS) nocardiosis is a rare infection that may affect both the brain and the spine in patients with immunodeficiency. 

CNS nocardiosis has been reported to represent ~2% of all cerebral abscesses, and to be present in 15-50% of patients with systemic infection 2-3

Symptoms may vary according to the type of presentation and its extension in the CNS: headache, nausea, vomiting, focal neurological deficit and seizures are reported as the most common 2-3

Nocardia spp. are aerobic and gram-positive bacilli which are saprophytic organisms ubiquitous in nature 1-3. The infection is acquired primarily by inhalation of the bacillus from the environment, then it can spread hematogenously to other organs and tissues 1-2. In the CNS the infection manifests as meningitis, granuloma with giant cells or cerebral abscesses 2

Identification of Nocardia spp. in the clinical laboratory can be challenging: the organism may growth on cultures in intervals between 4 days to 2–4 weeks 1.

This infection has no specific features to aid in suggesting the diagnosis. It typically manifests as a parenchymal abscess in any part of the brain, although spinal cord abscesses and meningitis have also been described 1,2.

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Article Information

rID: 39387
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • CNS nocardiosis
  • Central nervous system (CNS) nocardiosis
  • Nocardiosis: CNS manifestations

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