Infection and Drug Resistance (Nov 2023)
Cerebral Abscess Infected by Nocardia gipuzkoensis
Abstract
Xiaosi Li,1 Yan Feng,2 Dan Li,3 Liyang Chen,1 Mengli Shen,1 Hongsheng Li,1 Shuo Li,3 Xiaoyan Wu,1 Lingling Lu3 1Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China; 2Department of Clinical Laboratory, Jiaxing Maternity and Child Health Care Hospital Affiliated to Jiaxing University, Jiaxing, People’s Republic of China; 3Key laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co, Ltd, Hangzhou, People’s Republic of ChinaCorrespondence: Lingling Lu, Key laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co, Ltd, No. 329, Jinpeng Street, Sandun Town, West Lake District, Hangzhou, Zhejiang Province, 310000, People’s Republic of China, Tel +86-13587528187, Email [email protected] Xiaoyan Wu, Department of Clinical Laboratory, the Second Affiliated Hospital of Jiaxing University, No. 1518, North Huancheng Road, Nanhu District, Jiaxing, Zhejiang Province, 314000, People’s Republic of China, Tel +86-13586330218, Email [email protected]: Nocardia gipuzkoensis is a novel species that solely identified in patients with pulmonary infections by far. Growing evidence showed the excellent performance of metagenomics next-generation sequencing (mNGS) on pathogenic identification, especially for new species. Here, we described the first case of an elderly female patient suddenly suffering from neurological disorders owing to N. gipuzkoensis infection. And linezolid could effectively treat N. gipuzkoensis infection.Patients and Methods: The results of imaging, laboratory cultures, and mNGS, as well as therapeutic process are shared.Results: An elderly female patient suddenly suffered from neurological disorders with dysphasia and right limb trembles under no obvious causes. Subsequently, she was diagnosed as intracranial space-occupying lesions by magnetic resonance imaging (MRI). The isolate from brain secretion was further identified as N. gipuzkoensis through mNGS. The targeted therapy with linezolid according to the antimicrobial susceptibility was used to treat cerebral abscess induced by N. gipuzkoensis. During the follow-up, no relapse was observed for the patient after surgery for 104 days.Conclusion: Cerebral abscess induced by N. gipuzkoensis is rare disorder with high mortality. mNGS has been identified as a promising tool in pathogen diagnosis for timely therapy. Linezolid as one of the antimicrobial drugs could effectively treat N. gipuzkoensis infection and prevent adverse outcomes.Keywords: Nocardia gipuzkoensis, cerebral abscess, metagenomics next-generation sequencing, linezolid, mNGS
