Nocardial brain abscess in a patient with pulmonary alveolar proteinosis

Shirani, Kiana; Poulsen, Asger Nyborg; Hakamifard, Atousa

Nocardial brain abscess in a patient with pulmonary alveolar proteinosis

Authors

¹ Department of Infectious Diseases, Acquired Immunodeficiency Research Center, Isfahan, Iran

² Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

³ Department of Infectious Diseases, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Brain abscesses caused by Nocardiaare rare but have a very high mortality and specific requirements of antibiotic treatment. Nocardial brain abscesses are mainly found in patients with predisposing conditions such as pulmonary alveolar proteinosis (PAP), a disease associated with chronic exposure to silica dust. We present a case of multiple nocardial brain abscesses in a man with PAP probably due to long-term occupational exposure to silica dust. Conclusively, in patients presenting brain abscesses and a history of chronic exposure to silica dust, PAP and opportunistic nocardial infection should always be considered as possible diagnoses.

Keywords

References

1.	Menkü A, Kurtsoy A, Tucer B, Yildiz O, Akdemir H. Nocardia brain abscess mimicking brain tumour in immunocompetent patients: Report of two cases and review of the literature. ActaNeurochir (Wien) 2004;146:411-4.
2.	Kennedy KJ, Chung KH, Bowden FJ, Mews PJ, Pik JH, Fuller JW, et al. A cluster of nocardial brain abscesses. Surg Neurol 2007;68:43-9.
3.	Lin YJ, Yang KY, Ho JT, Lee TC, Wang HC, Su FW. Nocardial brain abscess. J ClinNeurosci 2010;17:250-3.
4.	Mamelak AN, Obana WG, Flaherty JF, Rosenblum ML. Nocardial brain abscess: Treatment strategies and factors influencing outcome. Neurosurgery 1994;35:622-31.
5.	Kilincer C, Hamamcioglu MK, Simsek O, Hicdonmez T, Aydoslu B, Tansel O, et al. Nocardial brain abscess: Review of clinical management. J Clin Neurosci 2006;13:481-5.
6.	Lerner PI. Nocardiosis. Clin Infect Dis 1996;22:891-905.
7.	Alavi Darazam I, Shamaei M, Mobarhan M, Ghasemi S, Tabarsi P, Motavasseli M, et al. Nocardiosis: Risk factors, clinical characteristics and outcome. Iran Red Crescent Med J 2013;15:436-9.
8.	Lerner PI. Nocardiosis, STATE-OF-THE-ART. Oxford Journals 1996;22:891-905.
9.	Bonella F, Bauer PC, Griese M, Ohshimo S, Guzman J, Costabel U. Pulmonary alveolar proteinosis: New insights from a single-center cohort of 70 patients. Respir Med 2011;105:1908-16.
10.	Sorerell TC, Mitchell DH, Iredell JR, Chen SC. Nocardia species. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett's Principles and practice of infectious disease. 7^th ed. Philadelphia: Churchill Livingstone; 2010. p. 3199-207.
11.	Punatar AD, Kusne S, Blair JE, Seville MT, Vikram HR. Opportunistic infections in patients with pulmonary alveolar proteinosis. J Infect 2012;65:173-9.
12.	Healy CB, Coggins MA, Van Tongeren M, MacCalman L, McGowan P. Determinants of respirable crystalline silica exposure among stoneworkers involved in stone restoration work. Ann Occup Hyg 2014;58:6-18.
13.	Meijer E, Kromhout H, Heederik D. Respiratory effects of exposure to low levels of concrete dust containing crystalline silica. Am J Ind Med 2001;40:133-40.

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