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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1979 Nov;42(11):1038–1045. doi: 10.1136/jnnp.42.11.1038

Nocardia cerebral abscess: New concepts in diagnosis, management, and prognosis.

E Byrne, B P Brophy, L V Perrett
PMCID: PMC490398  PMID: 501368

Abstract

Three cases of multiple cerebral nocardial abscess are presented. All were cured by a combination of chemotherapy and surgery, a unique experience. Early detection, appropriate chemotherapy, absence of underlying immune malfunction, and surgically remediable disease are good prognostic indices in cerebral nocardiosis. If other adverse prognostic factors are absent, however, multiple abscess formation does not preclude the possibility of cure. Accurate localisation of nocardia cerebral abscesses by computerised axial tomography is a great help in management if multiple lesions are present.

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Selected References

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