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Primary brain abscess with Nocardia otitidiscaviarum in an intravenous drug abuser

E. DURÁN, L. LÓPEZ, A. MARTÍNEZ, F. COMUÑAS^*, P. BOIRON and M.C. RUBIO

Service of Microbiology and *Neurosurgery, Clinic Hospital ‘Lozano Blesa', Zaragoza, Spain and Mycology Laboratory–EA1655, Faculty of Pharmacy, Lyon, France

Corresponding author: Dr E. Durán.

Received 7 Jan. 2000; accepted 21 May 2000.

Abstract

A primary brain abscess with Nocardia otitidiscaviarum in an intravenous drug abuser is reported. Nocardia brain abscess has been reported infrequently and normally only in immunocompromised patients. The lungs are the most common primary focus, but brain abscess may also occur following direct cutaneous inoculation. In this case the clinical presentation was first diagnosed as an astrocytoma. However, N. otitidiscaviarum was isolated from the lesion after emergency craniotomy. In contrast to five cases described previously the patient survived after surgical removal and antibiotic treatment with imipenem and trimethoprim-sulphamethoxazole.