PDF(Pubmed)
Abstract：
Nocardia is a genus of aerobic, Gram-positive, partially acid-fast, filamentous bacilli notoriously known for causing multisystemic infections in immunocompromised individuals. Notably, this genus of bacteria commonly infects the pleural and central nervous system, leading to pneumonia and brain abscesses, respectively. Our patient is a 71-year-old female who initially presented to the emergency department complaining of shortness of breath and altered mental status. Imaging revealed multiple enhancing brain lesions, a pleural effusion, and a paraspinal abscess, which upon aspiration and culture demonstrated Nocardia farcinica/kroppenstedtii. The patient underwent antibiotic treatment, including intravenous (IV) imipenem and trimethoprim/sulfamethoxazole (TMP-SMX), before being transitioned to oral TMP-SMX and amoxicillin/clavulanate. This case demonstrates the importance of diagnosing nocardiosis acutely and treating it appropriately.
摘要：
诺卡氏菌是有氧的一个属，革兰氏阳性,部分耐酸，众所周知，丝状杆菌在免疫功能低下的个体中引起多系统感染。值得注意的是,这种细菌通常会感染胸膜和中枢神经系统，导致肺炎和脑脓肿,分别。我们的患者是一名71岁的女性，最初到急诊科就诊，抱怨呼吸急促和精神状态改变。影像学显示多个增强的脑部病变，胸腔积液,还有一个椎旁脓肿,经抽吸和培养证明诺卡氏菌/kroppentedtii。病人接受了抗生素治疗,包括静脉注射（IV）亚胺培南和甲氧苄啶/磺胺甲恶唑（TMP-SMX），在过渡到口服TMP-SMX和阿莫西林/克拉维酸之前。此病例证明了急性诊断和适当治疗的重要性。
