Cerebral Abscess Infected by Nocardia gipuzkoensis

Figures & data

Figure 1 Imaging changes documented the alleviation of brain lesions during the timeline of treatment (a) The initial image of brain MRI at external healthcare center, and the section that indicated by red arrow represented intracranial space-occupying lesions. (b) The image of brain MRI before surgery in our hospital, the region that indicated by red arrows suggested further exacerbation of brain lesion. (c) The image of brain MRI in early postoperative, the region that indicated by red arrow documented the removal of cerebral abscess and existence of perilesional edema. (d) The brain CT scan of day 25 after surgery, documented recovered well of brain lesions without a relapse.

Table 1 Identification of Nocardia Genus in Cerebral Abscess Using mNGS

Genus				Species
Gram’s Staining	Genus Name	Relative Abundance	Sequences	Species Name	Confidence Level	Sequences
G+	Nocardia	99.7%	160,817	Nocardia gipuzkoensis	99%	27,163

Figure 2 Microbiology detection of N. gipuzkoensis. (a) The traditional culture of cerebral abscess with the pale yellow, rough, and dry colonies on Columbia Blood Agar medium. (b) The characteristic of weakly acid-fast was identified by acid-fast staining.

Table 2 Antimicrobial Drug Susceptibility Testing of Nocardia Gipuzkoensis

Num	Antibiotics	MIC for category (μg/mL)^Citation10			MIC for Nocardia	Interpretation
		Susceptible	Intermediate	Resistant
1	Meropenem	–	–	–	8	–
2	Amikacin	≤8	–	≥16	0.064	S
3	Linezolid	≤8	–	–	1	S
4	Vancomycin	–	–	–	16	R
5	Sulfamethoxazole-Trimethoprim	≤2/38		≥4/76	0.5/9.5	S
6	Imipenem	≤4	8	≥16	32	R
7	Ceftriaxone	≤8	16–32	≥64	1	S

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; R, resistance.

Table 3 Summarizes Some Data from the Case Literature of Cerebral Abscess Infected by Nocardia spp. in Patients

Nocardia spp.	Country	Gender	Age	Nocardia spp. Distribution	Other Comorbidities	Author, Year of Study
N. farcinica	USA	Male	55	Cerebral abscess	Pulmonary alveolar proteinosis	Grond, S. et al 2020^Citation14
	Indian	Female	76	Cerebral abscess	DM (poor-controlled)	Boctor, N. et al 2023^Citation15
	Northern Ireland	Male	53	Cerebral abscess	COPD, hypertension, chronic hyponatraemia	Holmes, D. et al 2018^Citation16
	France	Male	68	Cerebral abscess	Multinodular goiter with Graves orbitopathy, steroids treatment	Zayet, S. et al 2020^Citation17
	China	Male	55	Pulmonary and cerebral abscess	None	Bai, Y. H. et al 2021^Citation18
N. asteroides	Iran	Male	71	Cerebral abscess	T2DM, 2-month history of subcutaneous abscess of the right shoulder	Rahdar, H. A. et al 2022^Citation19
	Maroc	Female	60	Cerebral abscess	DM	Bopaka, R. G. et al 2014^Citation20
N. cyriacigeorgica	Israel	Male	75	Cerebral abscess	Ischemic heart disease, hypertension, chronic kidney disease, dyslipidemia, well-controlled mild asthma, hypothyroidism, locally invasive prostate carcinoma with good systemic control and complete remission under hormonal therapy.	Gabay, S. et al 2022^Citation21
	Iran	Female	73	Cerebral abscess	DM, chronic foot ulcer	Khorshidi, M. et al 2018^Citation22
	France	Male	66	Cerebral abscess	None	Courbin, V. et al 2022^Citation23
N. asiatica	Brazil	Female	40	Cerebral and mediastinal abscesses	HIV infection	de Azevedo, F. K. S. F. et al 2019^Citation24
	Korea	Male	51	Cerebral abscess	SLE	Jeong, J. H. et al 2017^Citation25
N. beijingensis	USA	Male	50	Cerebral abscess	HIV/AIDS	Keenan, J. G. et al 2017^Citation26
	USA	Male	58	Pulmonary and cerebral abscess	None	Alessandra Diioia et al 2021^Citation27
	Colombia	Male	58	Cerebral abscess	None	Solano-Varela, D. M. et al 2019^Citation28
N. cerradoensis	France	Female	59	Brain abscess	A renal transplant	Piau, C.et al 2015^15
N. lillensis	France	Female	37	Brain abscess	A heart transplant	Flateau, C. et al 2013^Citation29
N. araoensis	Japan	Male	73	Meningitis, ventriculitis and brain abscess	None	Yamamoto, F. et al 2017^Citation30
N. paucivorans	Japan	Female	52	Cerebellar abscess	DM (well-controlled)	Shimizu, Y. et al 2019^Citation31
N. mexicana	USA	/	/	Cerebral abscess	Allo-HCT	Majeed, A. et al 2017^Citation32

Abbreviations: DM, diabetes mellitus; T2DM, type 2 diabetes mellitus; SLE, systemic lupus erythematosus; COPD, chronic obstructive pulmonary disease; Allo-HCT, Allogenic hematopoietic stem cell transplant.

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