Multiple rim-enhancing brain lesions and pulmonary cavitary nodules as the presentation of Nocardia cyriacigeorgica in a patient with non–small cell lung cancer

Nocardiosis is caused by various strains of the genus Nocardia, a gram-positive, acid-fast bacillus found in organic matter. Disseminated nocardiosis with central nervous system involvement is a rare infection that is most commonly seen in immunocompromised patients. We present a case of a 67-year-o...

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Bibliographic Details
Published inProceedings - Baylor University. Medical Center Vol. 35; no. 4; pp. 555 - 556
Main Authors Bejcek, Alexis, Owens, Justin, Marella, Aditi, George, Aneesh
Format Journal Article
LanguageEnglish
Published Dallas Taylor & Francis Ltd 04.07.2022
Taylor & Francis
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Summary:Nocardiosis is caused by various strains of the genus Nocardia, a gram-positive, acid-fast bacillus found in organic matter. Disseminated nocardiosis with central nervous system involvement is a rare infection that is most commonly seen in immunocompromised patients. We present a case of a 67-year-old veteran with stage IV adenocarcinoma of the lung undergoing chemotherapy who presented with new cavitary pulmonary lesions. Three weeks into his hospitalization, a sputum culture with acid-fast staining returned positive for Nocardia cyriacigeorgica. A subsequent computed tomography scan of the head demonstrated numerous rim-enhancing lesions presumed to be due to disseminated nocardiosis with central nervous system involvement. Disseminated nocardiosis has a high mortality rate, making prompt detection and treatment paramount for these patients. Our case highlights the importance of considering central nervous system involvement in the evaluation of a patient with nocardiosis.
Bibliography:The authors report no funding or conflicts of interest. The patient gave permission for publication of this case.
ISSN:0899-8280
1525-3252
DOI:10.1080/08998280.2022.2058831