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Year : 2019  |  Volume : 14  |  Issue : 3  |  Page : 952-956

Nocardia araoensis causing brain abscess

1 Department of Neurosurgery, Aster Medcity, Kochi, Kerala, India
2 Department of Microbiology, Aster Medcity, Kochi, Kerala, India
3 Department of Infectious Diseases, Aster Medcity, Kochi, Kerala, India

Correspondence Address:
Shejoy Joshua
23, Marvel Mansions, Kathrikadavu, Kochi - 682 017, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_66_19

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Nocardial brain abscess is a rare central nervous system infection with high morbidity and mortality. Most of the human infections, i.e., about 90%, are due to Nocardia asteroides group comprising N. asteroides complex, Nocardia farcinica, and Nocardia nova. Other species rarely cause human infections. Here, we report a case of left parieto-occipital abscess caused by a rare species, Nocardia araoensis, its diagnosis, treatment options, and review of literature. A 73-year-old male, known case of diabetes mellitus, on prolonged oral corticosteroid for autoimmune hemolytic anemia presented with a 1-month history of memory deficit and gait imbalance. On examination, he had a right inferior quadrantanopia and hemiparesis. Magnetic resonance imaging showed a multiloculated ring-enhancing lesion in the left parieto-occipital region. Navigation-assisted biopsy was done. The organism isolated was N. araoensis. He was treated successfully with prolonged course of antibiotics which resulted in complete clinical and radiological resolution. N. araoensis is a rare cause of brain abscess and needs to be suspected in immunocompromised individuals. Early diagnosis and prolonged treatment can result in complete clinical and radiological resolution.

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