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Central nervous system (CNS) nocardiosis is a rare disease entity caused by the filamentous bacteria Nocardia species. We present a case series of 5 patients from our hospital and a review of the cases of CNS nocardiosis reported in the literature from January 2000 to December 2011. Our results indicate that CNS nocardiosis can occur in both immunocompromised and immunocompetent individuals and can be the result of prior pulmonary infection or can exist on its own. The most common predisposing factors are corticosteroid use (54% of patients) and organ transplantation (25%). Presentation of the disease is widely variable, and available diagnostic tests are far from perfect, often leading to delayed detection and initiation of treatment. The optimal therapeutic approach is still undetermined and depends on speciation, but lower mortality and relapse rates have been reported with a combination of targeted antimicrobial treatment including trimethoprim/sulfomethoxazole (TMP-SMX) for more than 6 months and neurosurgical intervention. |
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abscess,intracerebral abscess,intracerebral,recurrent bacterial infection bacterial infection,CNS central nervous system,infection of comorbidities delay in diagnosis fever headache human immunodeficiency virus type 1 immunocompetent immunosuppression immunosuppressive agents infection leukemia lymphoma meningitis,nocardia misdiagnosis MRI,abnormal neurologic complications of,chronic pulmonary disease nocardiosis opportunistic infection opportunistic infection,CNS organ transplantation prognosis pulmonary disease pulmonary infection pulmonary infiltrates recurrent review article seizure steroid treatment of neurologic disorder
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