Disseminated Cerebral and Intradural Extramedullary Spinal Nocardiosis in an Immunocompetent Patient

Meenal Sharma, Chris Anthony, Charlie Chia-Tsong Hsu, Catriona Maclean, Niki Martens
2015 European Journal of Case Reports in Internal Medicine  
Disseminated nocardiosis of the central nervous system (CNS) has been rarely reported, especially in the immunocompetent patient. We report a case of cerebral and cervical intradural extramedullary nocardiosis likely to have been the result of disseminated spread from a pulmonary infective focus. Attempts at tissue biopsy and culture of the initial cerebral and pulmonary lesions both failed to yield the diagnosis. Interval development of a symptomatic intradural extramedullary cervical lesion
more » ... sulted in open biopsy and an eventual diagnosis of nocardiosis was made. We highlight the diagnostic dilemma and rarity of spinal nocardial dissemination in an immunocompetent individual. LEARNING POINTS • Disseminated nocardiosis can occur in immunocompetent patents. • Systemic manifestations of sepsis suggested an infective aetiology. • When disseminated lesions are found, tissue diagnosis Is vital in directing management; in this case, biopsies were taken from both thoracic and spinal lesions.
doi:10.12890/2015_000207 fatcat:we6jana2djaglidtfoatqj2rdy