Table 2.
Clinical Presentation and Management of Patients With Nocardial Brain Abscess
| Cases | Age, Gender | Immunocompromised Host | Primary Source | Brain Abscess Location | Diameter, mma | Positive Blood Cultures | Nocardia Spp. on Direct Brain Abscess Sampling | Final Antibiotic Therapy | Final Antibiotic Route | Duration of Therapy, d | Type of Surgical Intervention | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 80, M | Yes | Pulmonary | Frontal | 12 | No | N. wallacei | Moxifloxacin, amikacin | Oral/IV | 84 | None | Diedb |
| 2 | 72, M | Yes | Skin | Frontal, parietal and midbrain | 17 | Yes | N. farcinica | TMP-SMX | IV | 180 | Open aspiration | Relapsed and died |
| 3 | 74, M | No | Unknown | Parietal, brain stem and cerebellum | 13 | No | N. farcinica | TMP-SMX | Oral | 336 | Open aspiration | Permanent neurologic deficit |
| 4 | 63, F | No | Pulmonary | Frontal, occipital and temporal | 21 | No | N. cyriacigeorgica | Ceftriaxone | IV | 168 | None | Cured |
| 5 | 77, F | No | CNS trauma | Temporal | 24 | No | Nocardia spp. | TMP-SMX, doxycycline | IV/oral | 168 | Open aspiration | Cured |
| 6 | 50, M | Yes | Unknown | Temporal | 41 | No | N. farcinica | Linezolid, amoxicillin-clavulanate | Oral | 224 | Open aspiration | Relapse and died |
| 7 | 94, M | Yes | Pulmonary | Temporal and parietal | 15 | No | N. farcinica | Linezolid, imipenem | Oral/IV | 14 | Stereotactic | Diedb |
| 8 | 73, F | No | Unknown | Parietal | 8 | No | N. wallacei | Linezolid, TMP-SMX, minocycline | Oral | 308 | None | Relapse and diedb |
| 9 | 65, M | Yes | Pulmonary | Cerebellum and forebrain | 10 | No | N. farcinica | TMP-SMX, moxifloxacin, doxycycline | Oral | 280 | None | Cured |
| 10 | 69, M | No | Pulmonary | Frontal | 10 | No | N. cyriacigeorgica | TMP-SMX | Oral | 365 | None | Required delayed surgical intervention |
| 11 | 50, M | Yes | Unknown | Parietal | 5 | No | N. otitidiscaviarum | TMP-SMX, amikacin | Oral/IV | 260 | None | Cured |
| 12 | 66, M | Yes | Skin | Brain stem | 4 | No | Nocardia spp. | TMP-SMX, amoxicillin-clavulanate | Oral | 365 | None | Cured |
| 13 | 49, M | No | Pulmonary | Parietal | 6.6 | Yes | N. farcinica | TMP-SMX, moxifloxacin | Oral | 365 | None | Cured |
| 14 | 61, M | Yes | Skin | Frontal | 4 | No | Nocardia spp. | TMP-SMX | Oral | 365 | None | Cured |
| 15 | 64, M | Yes | Unknown | Midbrain | 21 | No | Nocardia spp. | TMP-SMX | Oral | 365 | None | Permanent neurologic deficit |
| 16 | 60, F | Yes | Unknown | Temporal and parietal | 10 | No | N. argoensis | TMP-SMX, moxifloxacin | Oral | 365 | Open aspiration | Cured |
| 17 | 34, M | Yes | Pulmonary | Temporal | 26 | No | Nocardia spp. | TMP-SMX | Oral | 365 | Open aspiration | Cured |
| 18 | 64, M | Yes | Unknown | Occipital and temporal | 17 | No | N. cyriacigeorgica | Linezolid, TMP-SMX | Oral | 504 | Open aspiration | Cured |
| 19 | 50, M | Yes | CNS trauma | Frontal, occipital, temporal, and parietal | 13 | No | N. farcinica | TMP-SMX, ceftriaxone | Oral/IV | 196 | None | Died |
| 20 | 61, F | No | Unknown | Frontal | 10 | No | N. farcinica | Linezolid, ceftriaxone | Oral/IV | 182 | None | Cured |
| 21 | 69, M | No | Unknown | Parietal | 22 | No | N. farcinica | TMP-SMX | Oral | 365 | Stereotactic | Cured |
| 22 | 69, F | Yes | Pulmonary | Frontal | 20 | No | N. transvalensis | TMP-SMX, doxycycline | Oral | 365 | None | Cured |
| 23 | 58, M | No | Unknown | Frontal | 20 | No | N. abscessus | TMP-SMX, amoxicillin-clavulanate | Oral | 365 | Open aspiration | Cured |
| 24 | 63, M | Yes | Pulmonary | Frontal | 25 | Yes | N. wallacei | TMP-SMX, imipenem | Oral/IV | 20 | Stereotactic | Died |
Abbreviations: CNS, central nervous system; F, female; IV, intravenous; M, male; TMP-SMX, trimethoprim-sulfamethoxazole.
aDiameter of the largest lesion in cases when more than 1 lesion was present.
bDeath related to Nocardia infection.