A cluster of nocardial brain abscesses

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dc.contributor.authorKennedy, Karina
dc.contributor.authorChung, Carlos
dc.contributor.authorBowden, Francis
dc.contributor.authorMews, Peter J
dc.contributor.authorPik, Justin
dc.contributor.authorFuller, John W
dc.contributor.authorChandran, Nadana
dc.date.accessioned2015-12-07T22:39:03Z
dc.date.issued2007
dc.date.updated2015-12-07T10:44:37Z
dc.description.abstractBackground: Nocardia species are aerobic Gram-positive bacteria that are ubiquitous in the environment. Infection usually occurs through inhalation or direct cutaneous inoculation of the organism. It has been reported that infection is more common in warm, dry climates. Cerebral nocardiosis is an uncommon clinical entity, representing only 2% of all cerebral abscesses. It is an illness associated with significant morbidity and mortality. Case Descriptions: We report 4 cases of nocardial brain abscesses presenting to TCH, Australia, within a 1-year period. All 4 cases occurred in men without any significant underlying immunocompromise. In 3 of the cases, the diagnosis was only established after craniotomy. All cases were given prolonged antimicrobial therapy. After more than 8 months of follow-up, there have been no deaths or treatment failures. There has been only one other case of nocardial brain abscess at TCH over the past 15 years. We review the current literature on cerebral nocardiosis. Conclusion: Nocardial brain abscesses are uncommonly encountered at our institution. This cluster of 4 cases over a 1-year period has therefore led us to postulate that the severe drought may be aiding in the transmission of the bacteria. The cases also emphasize the propensity of nocardial infections to mimic other conditions, particularly malignancy, which may lead to delays in appropriate surgical treatment and antimicrobial therapy. The diagnosis requires a high clinical index of suspicion, with early tissue and microbiological diagnosis. Prolonged antimicrobial therapy is required to prevent relapse of the infection.
dc.identifier.issn0090-3019
dc.identifier.urihttp://hdl.handle.net/1885/23693
dc.publisherElsevier
dc.sourceSurgical Neurology (World Neurosurgery)
dc.subjectKeywords: albendazole; antiinfective agent; ceftriaxone; cotrimoxazole; dexamethasone; minocycline; phenytoin; sulfamethoxazole; add on therapy; adult; aged; antimicrobial therapy; article; Australia; bacterial transmission; brain abscess; case report; craniotomy; Brain abscess; Brain abscess diagnosis; Brain abscess surgery; Climate; Corticosteroids; Environmental change; Nocardia; Nocardia asteroides; Nocardiosis
dc.titleA cluster of nocardial brain abscesses
dc.typeJournal article
local.bibliographicCitation.lastpage49
local.bibliographicCitation.startpage43
local.contributor.affiliationKennedy, Karina, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationChung, Carlos, The Canberra Hospital
local.contributor.affiliationBowden, Francis, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMews, Peter J, The Canberra Hospital
local.contributor.affiliationPik, Justin, The Canberra Hospital
local.contributor.affiliationFuller, John W, The Canberra Hospital
local.contributor.affiliationChandran, Nadana, College of Medicine, Biology and Environment, ANU
local.contributor.authoremailu5097555@anu.edu.au
local.contributor.authoruidKennedy, Karina, u5097555
local.contributor.authoruidBowden, Francis, a177640
local.contributor.authoruidChandran, Nadana, a265698
local.description.embargo2037-12-31
local.description.notesImported from ARIES
local.identifier.absfor110323 - Surgery
local.identifier.ariespublicationu4241283xPUB28
local.identifier.citationvolume68
local.identifier.doi10.1016/j.surneu.2006.08.067
local.identifier.scopusID2-s2.0-34250659748
local.identifier.uidSubmittedByu4241283
local.type.statusPublished Version

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