Nocardia farcinica Brain Abscess Preceded by Non-Resolving Pneumonia: A Case Report and literature Review

I-Yuan Chen；Chien-Wei Hsu；Wei-Cheng Hong；David-Lin Lee

Nocardia farcinica ； nocardiosis ； brain abscess

胸腔醫學

39卷3期（2024 / 09 / 01）

241 - 248

英文

Nocardia spp. are considered to be opportunistic pathogens. Pulmonary nocardiosis is the most common clinical presentation of infection, and primary infection can lead to hematogenous spread to multiple organs. The relatively slow growth on culture media and the difficulties in recognizing colony morphology result in difficulties in laboratory diagnosis, leading to delayed diagnosis. Currently, there is no universal consensus regarding the initial choice of antibiotics for nocardiosis, although trimethoprim-sulfamethoxazole remains the mainstay of a primary treatment regimen. Treatment for pulmonary nocardiosis requires at least 6 months, while central nervous system (CNS) involvement necessitates treatment for at least for 12 months. If CNS nocardiosis fails to respond to medical therapy, surgical intervention is required. Here, we report a case of brain abscess caused by Nocardia farcinica, which was preceded by non-resolving pneumonia for almost 5 months. Significant regression of the pneumonia patch was observed after initiating antibiotic treatment for nocardiosis.