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Ventriculitis and choroid plexitis caused by multidrug-resistant Nocardia pseudobrasiliensis

Kanokporn Mongkolrattanothai1, Sreemdevi Ramakrishnan, Michael Zagardo

  • 1Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Illinois College of Medicine of Peoria and Children's Hospital of Illinois, USA. kmongkol@uic.edu

The Pediatric Infectious Disease Journal
|June 4, 2008
PubMed

Insights

A rare Nocardia pseudobrasiliensis infection caused ventriculitis and choroid plexitis in an immunocompetent child. Treatment challenges included diagnosis and antibiotic resistance, but a favorable outcome was achieved.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Microbiology

Background:

  • Central nervous system infections are rare in immunocompetent children.
  • Nocardia species are emerging pathogens, particularly in immunocompromised individuals.

Observation:

  • A case of ventriculitis and choroid plexitis caused by multidrug-resistant Nocardia pseudobrasiliensis in an immunocompetent child.
  • The patient presented with complex neurological symptoms requiring extensive diagnostic workup.

Findings:

  • Establishing an etiologic diagnosis was challenging due to the rarity of the pathogen and atypical presentation.
  • Inconsistencies in antibiotic susceptibility testing complicated antimicrobial selection.
  • The patient experienced side effects from various antimicrobial agents during treatment.

Implications:

  • This case highlights the importance of considering Nocardia species in the differential diagnosis of central nervous system infections, even in immunocompetent hosts.
  • Challenges in diagnosis and treatment underscore the need for improved diagnostic tools and antimicrobial susceptibility testing for Nocardia.
  • Successful management of this rare infection emphasizes the importance of a multidisciplinary approach and persistent therapeutic strategies.

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