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Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy

BACKGROUND: Nocardia species are ubiquitous in nature and mainly cause pulmonary disease in humans; however, they can also infect the central nervous system and skin. The management of cerebellar nocardiosis is troublesome and requires multiple considerations of the severity of the underlying system...

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Autores principales: Shimizu, Yu, Tsuchiya, Katsuhiro, Fujisawa, Hironori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416759/
https://www.ncbi.nlm.nih.gov/pubmed/31123629
http://dx.doi.org/10.4103/sni.sni_370_18
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author Shimizu, Yu
Tsuchiya, Katsuhiro
Fujisawa, Hironori
author_facet Shimizu, Yu
Tsuchiya, Katsuhiro
Fujisawa, Hironori
author_sort Shimizu, Yu
collection PubMed
description BACKGROUND: Nocardia species are ubiquitous in nature and mainly cause pulmonary disease in humans; however, they can also infect the central nervous system and skin. The management of cerebellar nocardiosis is troublesome and requires multiple considerations of the severity of the underlying systemic disease, difficulties in identifying the bacterium, and frequent delay in initiating adequate therapy. CASE DESCRIPTION: We report a 52-year-old diabetic female patient with Nocardia paucivorans cerebellar abscesses. Brain magnetic resonance imaging (MRI) revealed innumerable small ring-enhancing lesions of posterior fossa. In this report, we present a case of primary single cerebellar abscesses due to N. paucivorans. Early diagnosis and surgical interventions were significant for the patient. The diagnosis was confirmed by DNA sequencing and the organism was susceptible to trimethoprim–sulfamethoxazole (TMP/SMX). The patient was successfully treated with drugs and surgical excision. CONCLUSION: According to the literature, surgical excision or aspiration of cerebellar abscess seems to provide favorable outcomes. In our experience, a successful outcome was achieved with subtotal resection and prolonged adequate antibiotic therapy.
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spelling pubmed-64167592019-05-23 Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy Shimizu, Yu Tsuchiya, Katsuhiro Fujisawa, Hironori Surg Neurol Int Infection: Case Report BACKGROUND: Nocardia species are ubiquitous in nature and mainly cause pulmonary disease in humans; however, they can also infect the central nervous system and skin. The management of cerebellar nocardiosis is troublesome and requires multiple considerations of the severity of the underlying systemic disease, difficulties in identifying the bacterium, and frequent delay in initiating adequate therapy. CASE DESCRIPTION: We report a 52-year-old diabetic female patient with Nocardia paucivorans cerebellar abscesses. Brain magnetic resonance imaging (MRI) revealed innumerable small ring-enhancing lesions of posterior fossa. In this report, we present a case of primary single cerebellar abscesses due to N. paucivorans. Early diagnosis and surgical interventions were significant for the patient. The diagnosis was confirmed by DNA sequencing and the organism was susceptible to trimethoprim–sulfamethoxazole (TMP/SMX). The patient was successfully treated with drugs and surgical excision. CONCLUSION: According to the literature, surgical excision or aspiration of cerebellar abscess seems to provide favorable outcomes. In our experience, a successful outcome was achieved with subtotal resection and prolonged adequate antibiotic therapy. Medknow Publications & Media Pvt Ltd 2019-02-22 /pmc/articles/PMC6416759/ /pubmed/31123629 http://dx.doi.org/10.4103/sni.sni_370_18 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Infection: Case Report
Shimizu, Yu
Tsuchiya, Katsuhiro
Fujisawa, Hironori
Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title_full Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title_fullStr Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title_full_unstemmed Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title_short Nocardia paucivorans cerebellar abscess: Surgical and pharmacotherapy
title_sort nocardia paucivorans cerebellar abscess: surgical and pharmacotherapy
topic Infection: Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416759/
https://www.ncbi.nlm.nih.gov/pubmed/31123629
http://dx.doi.org/10.4103/sni.sni_370_18
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