Diagnosis and Neurosurgical Management of Cerebral Nocardiosis.

IF 0.6 Q4 CLINICAL NEUROLOGY Journal of Neurological Surgery Reports Pub Date : 2021-08-10 eCollection Date: 2021-07-01 DOI:10.1055/s-0040-1722345
Carley Karam, Abdolreza Siadati
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引用次数: 1

Abstract

Primary Nocardia infections are uncommon gram-positive bacterial infections caused by aerobic actinomycetes and are typically regarded as opportunistic infections (only one-third of infected patients are immunocompetent). Risk factors include: glucocorticoid therapy, malignancy, organ transplant recipients, human immunodeficiency virus infections, tumor necrosis factor-α inhibitor therapy, diabetes mellitus, alcoholism, inflammatory bowel disease, chronic obstructive pulmonary disease, chronic granulomatous disease, and tuberculosis. The organism has a predisposition to disseminate to the central nervous system and can relapse or progress despite appropriate therapy. Treatment ranges from oral antibiotic management to multiple intravenous antibiotic therapy, with surgical intervention required for severe cases. The surgical options include aspiration or complete excision of abscess contents and capsule. In the present case, we describe the use of bilateral craniotomy with assisted image guidance and multiple abscess excision in an immunocompetent patient with systemic nocardiosis.

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脑诺卡菌病的诊断和神经外科治疗。
原发性诺卡菌感染是由需氧放线菌引起的罕见革兰氏阳性细菌感染,通常被认为是机会性感染(只有三分之一的感染患者具有免疫能力)。危险因素包括:糖皮质激素治疗、恶性肿瘤、器官移植受者、人类免疫缺陷病毒感染、肿瘤坏死因子-α抑制剂治疗、糖尿病、酒精中毒、炎症性肠病、慢性阻塞性肺病、慢性肉芽肿病和结核病。这种生物有扩散到中枢神经系统的倾向,尽管有适当的治疗,也可能复发或进展。治疗范围从口服抗生素管理到多次静脉注射抗生素治疗,严重病例需要手术干预。手术选择包括抽吸或完全切除脓肿内容物和脓包。在本病例中,我们描述了在免疫功能正常的全身诺卡菌病患者中使用辅助图像引导的双侧开颅术和多发性脓肿切除术。
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发文量
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审稿时长
12 weeks
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