Nocardial brain abscess mimicking lung cancer metastasis in immunocompetent patient with pulmonary nocardiasis: a case report. 2019

Mladen Karan, and Nada Vučković, and Petar Vuleković, and Ante Rotim, and Nebojša Lasica, and Lukas Rasulić
1Department of Surgery, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2Department of Pathology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Pathology and Histology Center, Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia; 6Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 7Department of Neurosurgery, Clinical Centre of Serbia, Belgrade, Serbia.

Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. Immunocompetent and immunocompromised patients both can be affected and Nocardia cyriacigeorgica was reported as a pathogen isolated in patients worldwide. In most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise awareness of the possibility for this rare but potentially fatal condition. We present a case where nocardial abscesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297 Male Males
D009362 Neoplasm Metastasis The transfer of a neoplasm from one organ or part of the body to another remote from the primary site. Metastase,Metastasis,Metastases, Neoplasm,Metastasis, Neoplasm,Neoplasm Metastases,Metastases
D009617 Nocardia Infections Infections with bacteria of the genus NOCARDIA. Cerebral Nocardiosis,Infections, Nocardia,Nocardia asteroides Infection,Nocardiosis,Primary Cutaneous Nocardiosis,Pulmonary Nocardiosis,Cerebral Nocardioses,Cutaneous Nocardioses, Primary,Cutaneous Nocardiosis, Primary,Infection, Nocardia,Infection, Nocardia asteroides,Infections, Nocardia asteroides,Nocardia Infection,Nocardia asteroides Infections,Nocardioses,Nocardioses, Cerebral,Nocardioses, Primary Cutaneous,Nocardioses, Pulmonary,Nocardiosis, Cerebral,Nocardiosis, Primary Cutaneous,Nocardiosis, Pulmonary,Primary Cutaneous Nocardioses,Pulmonary Nocardioses
D001922 Brain Abscess A circumscribed collection of purulent exudate in the brain, due to bacterial and other infections. The majority are caused by spread of infected material from a focus of suppuration elsewhere in the body, notably the PARANASAL SINUSES, middle ear (see EAR, MIDDLE); HEART (see also ENDOCARDITIS, BACTERIAL), and LUNG. Penetrating CRANIOCEREBRAL TRAUMA and NEUROSURGICAL PROCEDURES may also be associated with this condition. Clinical manifestations include HEADACHE; SEIZURES; focal neurologic deficits; and alterations of consciousness. (Adams et al., Principles of Neurology, 6th ed, pp712-6) Brain Abscess, Child,Brain Abscess, Multiple,Brain Abscess, Pyogenic,Brain Abscess, Sterile,Cerebral Abscess,Abscess, Brain,Abscess, Cerebral,Abscess, Child Brain,Abscess, Multiple Brain,Abscess, Pyogenic Brain,Abscesses, Cerebral,Abscesses, Multiple Brain,Brain Abscesses,Brain Abscesses, Multiple,Brain Abscesses, Pyogenic,Brain Abscesses, Sterile,Cerebral Abscesses,Child Brain Abscess,Multiple Brain Abscess,Multiple Brain Abscesses,Pyogenic Brain Abscess,Pyogenic Brain Abscesses,Sterile Brain Abscess,Sterile Brain Abscesses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D016867 Immunocompromised Host A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Immunosuppressed Host,Immunocompromised Patient,Host, Immunocompromised,Host, Immunosuppressed,Hosts, Immunocompromised,Hosts, Immunosuppressed,Immunocompromised Hosts,Immunocompromised Patients,Immunosuppressed Hosts,Patient, Immunocompromised,Patients, Immunocompromised
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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