Primary Brain Abscess Caused by Nocardia terpenica: a Case Report and Literature Review
Abstract
BACKGROUND: Nocardia terpenica is an exceptionally rare opportunistic pathogen, with infections scarcely documented in clinical practice. We report the first case of primary brain abscess caused by Nocardia terpenica and present a comprehensive review of the microbiological features and clinical presentations associated with this pathogen.
METHODS: The patient underwent intracranial puncture and drainage due to a brain abscess. During the procedure, cerebrospinal fluid (CSF) was collected for culture. The isolated pathogen was subjected to Gram staining and modified acid-fast staining. Identification was carried out using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Susceptibility testing was performed using the microbroth dilution method.
RESULTS: CSF culture on blood agar plates yielded small, white, agar-biting colonies. Gram staining revealed Gram-positive branching bacilli, and modified acid-fast staining was positive, suggesting Nocardia spp. MALDI-TOF MS (AnTu, China) confirmed Nocardia terpenica. Microbroth dilution susceptibility testing (35°C, 5 days) showed the isolate was susceptible to trimethoprim-sulfamethoxazole, minocycline, ciprofloxacin, moxifloxacin, clarithromycin, linezolid, tobramycin, amikacin, and imipenem, but resistant to ceftriaxone and amoxicillin-clavulanate. The patient was treated with linezolid, meropenem, and trimethoprim-sulfamethoxazole.
CONCLUSIONS: For patients with Nocardia terpenica…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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