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Meningitis and Ventriculitis due to Nocardia araoensis Infection

Fumio Yamamoto1, Satoshi Yamashita, Hiroyuki Kawano

  • 1Division of Neurology, Minamata City Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|April 7, 2017
PubMed

Insights

This case report details a rare Nocardia araoensis meningitis infection in a 73-year-old man. The infection led to ventriculitis and brain abscess, ultimately proving fatal despite treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Meningitis, ventriculitis, and brain abscess are severe central nervous system infections.
  • Nocardia species are aerobic actinomycetes, some of which can cause opportunistic infections.

Observation:

  • A 73-year-old male presented with altered consciousness, fever, and headache.
  • Cerebrospinal fluid analysis showed neutrophilic pleocytosis, elevated protein, and low glucose.
  • Initial cultures were negative, and empirical treatment for meningitis was initiated.

Findings:

  • Autopsy revealed meningitis, ventriculitis, and brain abscess.
  • Nocardia araoensis was identified in pus from the left lateral ventricle.
  • This is the first reported case of N. araoensis meningitis complicated by ventriculitis and brain abscess.

Implications:

  • Highlights Nocardia araoensis as a potential pathogen in severe CNS infections.
  • Emphasizes the importance of considering unusual pathogens in refractory meningitis.
  • Underscores the diagnostic challenges posed by negative initial CSF cultures.

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