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

Acta Clin Croat. 2019 Sep;58(3):540-545. doi: 10.20471/acc.2019.58.03.20.

Abstract

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.

Keywords: Brain abscess; Case reports; Lung neoplasms; Nocardia, infections.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Brain Abscess / drug therapy*
  • Brain Abscess / etiology*
  • Brain Abscess / physiopathology
  • Humans
  • Immunocompromised Host
  • Lung Neoplasms / complications*
  • Lung Neoplasms / physiopathology
  • Male
  • Neoplasm Metastasis / physiopathology*
  • Nocardia Infections / complications
  • Nocardia Infections / drug therapy*
  • Nocardia Infections / surgery*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents