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Background <p>Nocardia brain abscess is extremely rare. Vogt-Koyanagi-Harada disease is an autoimmune driven inflammation of ocular, auditory and meningeal structures that all contain melanocyes, treated by high dose systemic steroid drugs and immunosuppressive therapy. There is high mortality in patients with nocardia brain abscess and there are no clear guidelines for treatment as disease is rare. Article about successful treatment of nocardia brain abscess can be helpful for treatment of similar patients in other parts of world and in making guidelines for the standard treatment protocols and follow up protocols.</p> Presentation <p>58&#xa0;years old female patient was admitted with complaints of headache, decreased vision and hearing, right hemiparesis, vitiligo, poliosis, alopecia and blackish discoloration of left thumb and index finger nails with history of Vogt-Koyanagi-Harada syndrome, treated with steroids and methotrexate for three months. She developed Nocardial brain abcess and was treated successfully with surgery followed by medical treatment.</p> Conclusion <p>Brain abscess caused by nocardia is a rare, but challenging one with high mortality rate. Diagnosis depends on a high index of clinical suspicion along with accurate microbiological findings. Detailed studies are required for deciding the treatment. Strict regular clinical and radiological monitoring for long term is required.</p>

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Brain abscess caused by nocardia farcinica in a patient with Vogt-Koyanagi-Harada syndrome

  • 期刊论文

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  • 发表日期：

    2025年3月21日

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  • Ravishankar S. Goel,
  • Vikram Dua,
  • Sachin Gupta,
  • Reemu Bansal,
  • Neha Rathor

摘要

Background

Nocardia brain abscess is extremely rare. Vogt-Koyanagi-Harada disease is an autoimmune driven inflammation of ocular, auditory and meningeal structures that all contain melanocyes, treated by high dose systemic steroid drugs and immunosuppressive therapy. There is high mortality in patients with nocardia brain abscess and there are no clear guidelines for treatment as disease is rare. Article about successful treatment of nocardia brain abscess can be helpful for treatment of similar patients in other parts of world and in making guidelines for the standard treatment protocols and follow up protocols.

Presentation

58 years old female patient was admitted with complaints of headache, decreased vision and hearing, right hemiparesis, vitiligo, poliosis, alopecia and blackish discoloration of left thumb and index finger nails with history of Vogt-Koyanagi-Harada syndrome, treated with steroids and methotrexate for three months. She developed Nocardial brain abcess and was treated successfully with surgery followed by medical treatment.

Conclusion

Brain abscess caused by nocardia is a rare, but challenging one with high mortality rate. Diagnosis depends on a high index of clinical suspicion along with accurate microbiological findings. Detailed studies are required for deciding the treatment. Strict regular clinical and radiological monitoring for long term is required.