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KMID : 1201420230160020107
Journal of Neurocritical Care
2023 Volume.16 No. 2 p.107 ~ p.110
Disseminated nocardiosis including cerebral nocardiosis caused by Nocardia farcinica: a case report
Song Bae-Seoup

Kim Dong-Youn
Kim Young-Jin
Woo Ho-Geol
Abstract
Background: As nocardiosis presents with nonspecific symptoms, its diagnosis is often difficult, resulting in high mortality. Here, we report a rare case of disseminated Nocardia farcinica infection that was successfully managed with a combination of antibiotic therapies.

Case report: A 71-year-old man with idiopathic thrombocytopenia purpura presented with sudden-onset motor aphasia, motor weakness of the right limb, and fever. Brain magnetic resonance imaging revealed multiple scattered diffusion-restricted lesions. Multiple cutaneous and peritoneal nodules were also identified. We performed full-length 16S ribosomal ribonucleic acid (rRNA) sequencing and obtained basic local alignment search tool results against the National Center for Biotechnology Information 16S rRNA database, which showed the best match to be N. farcinica. After maintaining the antibiotics for approximately 56 days, the patient recovered full consciousness, and the motor weakness of the right limb improved.

Conclusion: Timely diagnosis of disseminated or cerebral nocardiosis and treatment with appropriate antibiotics are crucial for a desirable clinical outcome.
KEYWORD
Nocardiosis, Brain abscess, 16S rRNA, Sequence analysis
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