Nocardiosis (central nervous system manifestations)
Updates to Article Attributes
Central nervous system (CNS) nocardiosis is a rare infection that may affect both the brain and the spine in in patients with immunodeficiency.
Epidemiology
CNS nocardiosis has been reported to represent ~2% of all cerebral abscesses, and to be present in 15-50% of patients with systemic infection 2-3.
Clinical presentation
Symptoms may vary according to the type of presentation and its extension in the CNS: headache, nausea, vomiting, focal neurological deficit and seizures are reported as the most common 2-3.
Pathology
Nocardiaspp. are aerobic and gram-positive bacilli which are saprophytic saprophytic organisms ubiquitous in nature 1-3. The infection is acquired primarily by inhalation of the bacillus from the environment, then it can spread hematogenously to other organs and tissues 1-2. In the CNS the infection manifests as meningitis, granuloma with giant cells or cerebral abscesses 2.
Identification ofNocardia spp spp. in the clinical laboratory can be challenging: the organism may growth on cultures in intervals between 4 days to 2–4 weeks 1.
Radiographic features
This infection has infection has no specific features to aid in suggesting the diagnosis. It typically typically manifests as a parenchymal abscess in any part of the brain, although spinal cord abscesses and meningitis have also been described 1,2.
-<p><strong>Central nervous system (CNS) nocardiosis</strong> is a rare <a href="/articles/cns-infectious-diseases">infection</a> that may affect both the brain and the spine in patients with immunodeficiency. </p><h4>Epidemiology</h4><p>CNS nocardiosis has been reported to represent ~2% of all <a title="Cerebral abscesses" href="/articles/brain-abscess-1">cerebral abscesses</a>, and to be present in 15-50% of patients with systemic infection <sup>2-3</sup>. </p><h4>Clinical presentation</h4><p>Symptoms may vary according to the type of presentation and its extension in the CNS: headache, nausea, vomiting, focal neurological deficit and seizures are reported as the most common <sup>2-3</sup>. </p><h4>Pathology</h4><p><em>Nocardia </em><em>spp.</em> are aerobic and gram-positive bacilli which are saprophytic organisms ubiquitous in nature <sup>1-3</sup>. The infection is acquired primarily by inhalation of the bacillus from the environment, then it can spread hematogenously to other organs and tissues <sup>1-2</sup>. In the CNS the infection manifests as <a href="/articles/pyogenic-meningitis">meningitides</a>, granuloma with giant cells or <a href="/articles/brain-abscess-1">cerebral abscesses</a> <sup>2</sup>. </p><p>Identification of <em>Nocardia spp. </em>in the clinical laboratory can be challenging: the organism may growth on cultures in intervals between 4 days to 2–4 weeks <sup>1</sup>.</p><h4>Radiographic features</h4><p>This infection has no specific features to aid in suggesting the diagnosis. It typically manifests as a <a href="/articles/brain-abscess-1">parenchymal abscess</a> in any part of the brain, although spinal cord abscesses and <a href="/articles/leptomeningitis">meningitis</a> have also been described <sup>1,2</sup>.</p>- +<p><strong>Central nervous system (CNS) nocardiosis</strong> is a rare <a href="/articles/cns-infectious-diseases">infection</a> that may affect both the brain and the spine in patients with immunodeficiency. </p><h4>Epidemiology</h4><p>CNS nocardiosis has been reported to represent ~2% of all <a href="/articles/brain-abscess-1">cerebral abscesses</a>, and to be present in 15-50% of patients with systemic infection <sup>2-3</sup>. </p><h4>Clinical presentation</h4><p>Symptoms may vary according to the type of presentation and its extension in the CNS: headache, nausea, vomiting, focal neurological deficit and seizures are reported as the most common <sup>2-3</sup>. </p><h4>Pathology</h4><p><em>Nocardia </em><em>spp.</em> are aerobic and gram-positive bacilli which are saprophytic organisms ubiquitous in nature <sup>1-3</sup>. The infection is acquired primarily by inhalation of the bacillus from the environment, then it can spread hematogenously to other organs and tissues <sup>1-2</sup>. In the CNS the infection manifests as <a title="Pyogenic meningitis" href="/articles/pyogenic-meningitis">meningitis</a>, granuloma with giant cells or <a href="/articles/brain-abscess-1">cerebral abscesses</a> <sup>2</sup>. </p><p>Identification of <em>Nocardia spp. </em>in the clinical laboratory can be challenging: the organism may growth on cultures in intervals between 4 days to 2–4 weeks <sup>1</sup>.</p><h4>Radiographic features</h4><p>This infection has no specific features to aid in suggesting the diagnosis. It typically manifests as a <a href="/articles/brain-abscess-1">parenchymal abscess</a> in any part of the brain, although spinal cord abscesses and <a href="/articles/leptomeningitis">meningitis</a> have also been described <sup>1,2</sup>.</p>
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