Abscesso cerebelar por Nocardia: relato de caso

Aguiar, Paulo H.P.; Pahl, Félix H.; Uip, David E.; Vellutini, Eduardo A. S.; Mutarelli, Eduardo G.; Taricco, Mario A.; Gomes, Marcos Q. T.; Loreto, Celso D.L

doi:10.1590/S0004-282X1995000200024

Resumos

A nocardiose do sistema nervoso central tem alcançado importante destaque no diagnóstico diferencial de patologias tumorais nos últimos anos pelo aumento da incidência de pacientes imunodeficiêntes(pacientes submetidos a quimioterapia, transplante de órgãos ou com a síndrome de imunodeficiência adquirida - SIDA). Os autores descrevem o caso de um paciente com SIDA que desenvolveu nocardiose cerebelar na sua forma tumoral. O paciente foi submetido a craniectomia de fossa posterior para diagnóstico e tratamento. Os achados de neuroimagem e patológicos bem como a conduta cirúrgica são discutidos com base em revisão da literatura.

nocardiose; abcesso cerebelar; síndrome de imunodeficiência adquirida (SIDA)

The authors describe a case of cerebellar abscess by Nocardiain a patient with the acquired immunodeficiency syndrome (AIDS) that was submitted to a posterior fossa craniectomy for diagnosis and treatment. Pathological and neuroimage findings are discussed as well as the surgical approach taking into account literature data on the subject.

nocardial infection; cerebellar abscess; acquired immunodeficiency syndrome (Aids)

Abscesso cerebelar por Nocardia:relato de caso

Cerebellar abscess by Nocardia:case report

Paulo H.P. AguiarI; Félix H. Pahl^I; David E. Uip^II; Eduardo A. S. Vellutini^I; Eduardo G. Mutarelli^I; Mario A. Taricco^I; Marcos Q. T. Gomes^I; Celso D.L Loreto^III

^IMédico do Serviço de Neurologia e Neurocirurgia do Hospital Alemão Oswaldo Cruz São Paulo, (HAOC)

^IIMédico Infectologista do HAOC

^IIIMédico do Serviço de Patologia do HAOC

RESUMO

A nocardiose do sistema nervoso central tem alcançado importante destaque no diagnóstico diferencial de patologias tumorais nos últimos anos pelo aumento da incidência de pacientes imunodeficiêntes(pacientes submetidos a quimioterapia, transplante de órgãos ou com a síndrome de imunodeficiência adquirida - SIDA). Os autores descrevem o caso de um paciente com SIDA que desenvolveu nocardiose cerebelar na sua forma tumoral. O paciente foi submetido a craniectomia de fossa posterior para diagnóstico e tratamento. Os achados de neuroimagem e patológicos bem como a conduta cirúrgica são discutidos com base em revisão da literatura.

Palavras-chave:nocardiose, abcesso cerebelar, síndrome de imunodeficiência adquirida (SIDA)

SUMMARY

The authors describe a case of cerebellar abscess by Nocardiain a patient with the acquired immunodeficiency syndrome (AIDS) that was submitted to a posterior fossa craniectomy for diagnosis and treatment. Pathological and neuroimage findings are discussed as well as the surgical approach taking into account literature data on the subject.

Key-words: nocardial infection, cerebellar abscess, acquired immunodeficiency syndrome (Aids).

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Aceite: 3 - dezembro - 1994.

Dr. Paulo Henrique Pires de Aguiar - Rua Raul Pompéia 1050 apto.lll- 05025-010 São Paulo SP - Brasil. Fax (011) 289-0661.

1. Armstrong D, Wong B. Central nervous system infection in immunocompromised hosts.Annu Rev Med 1982, 33: 293-308.
2. Beaman B, Burnside J, Edwards B, Causey W. Nocardial infection in the United States 1972-1974. J Infect Dis 1976, 134: 286-289.
3. Byrne E, Brophy BP, Pettet LV. Nocardia cerebral abscess: new concepts in diagnosis, management and prognosis. J Neurol Neurosurg Psychiatry 1979, 48: 1038-1045.
4. Coker RJ, Bignardi G, Homer P, Savage M, Cook T, Tomlinson D, Weber J. Nocardia infection in AIDS: a clinical and microbiological challenge. J Clin Pathol 1992, 45: 821-822.
5. Filice GA, Simpson GL: Management of Nocardia infection. Curr Clin Trap Infect Dis 1984, 5: 49-64.
6. Frazier AR, Rosenow EC III, Roberts GD. Nocardiosis: a review of 25 cases ocurring during 24 months. Mayo Clin Proc 1975, 50: 657-663,
7. Gilligan BS, Williams L. Nocardial meningitis: report of a case with bacteriological studies. Med J Aust 1962,2: 747-752.
8. Kirmani N, Tuazon CU, Oclin JA, Thompson AM, Kramer NC, Geelhoed GW. Extensive cerebral nocardiosis cured with antibiotic therapy alone. J Neurosurg 1978, 49: 924-928.
9. Krueger EG, Norsa L, Kenney M, Price PA. Nocardiosis of the central nervous system. J Neurosurg 1954, 11: 226-233.
10. Lee C, Dorman DC, Bradhurst PG. Disseminated nocardiosis: an acute fatal episode in a young girl. Aust Med J 1963, 2: 536-541.
11. Mandell W, Neu HC. Nocardial infections. In Vinken PJ, Bruyn GW, Klawans HL (eds). Handbook of clinical neurology, vol 52 (Microbial Disease). Amsterdam: Elsevier, 1988, p 445-453.
12. Norden CW, Ruben FL, Selker R. Nonsurgical treatment of cerebral nocardiosis. Arch Neurol 1983, 40: 594-595.
13. Pizzolato P, Ziskind J, Derman H, Buff EE. Nocardiosis of the brain: report of three cases. Am J Clin Pathol 1961, 36: 151-156.
14. Rosenblum ML, Rosegay A. Resection of multiple nocardial brain abscesses : diagnostic role of computadorized tomography. Neurosurgery 1979 , 4: 315-318.
15. Simpson GL, Stinson EB, Egger MJ, Remington JS. Nocardial infections in the immunocompromised host: a detailed study in a defined population. Rev Infect Dis 1981, 3: 492-507.
16. Smego RA Jr, Gallis HA. The clinical spectrum of nocardia brasiliensis infection in the United States. Rev Infect Dis 1981,6: 164-180.
17. Smego RA Jr, Moeller MB, Gallis HA. Trimethoprim-sulfamethoxazole therapy of Nocardia infections. Arch Intern Med 1983, 143: 711-718.
18. Smith PW, Steinkraus GE, Henricks BW, Madson EC. CNS nocardiosis: response to sulfamethoxazole therapy of Nocardia infections. Arch Neurol 1980, 37: 729-730.
19. Teleghani-Far M, Barber JB, Simpson C, Harden KA. Cerebral nocardiosis and alveolar proteinosis. Am Rev Respir Dis 1964 , 89: 561-565.
20. Turner E, Whitby JW. Nocardial cerebral abscess with systemic involvement successfully treated by aspiration and sulfonamides: case report. J Neurosurg 1969 , 31: 227-229.
21. Viroslav J, Williams TW Jr. Nocardial infection of the pulmonary and central nervous system: successful treatment with medical therapy. South Med J 1971, 64: 1382-1385.
22. Zimmerman RA. Magnetic resonance imaging of intracranial infections. In Wilkins RH, Rengachary SS (eds). Neurosurgery update: I. Diagnosis, operative technique, and neuro-oncology. New York: Mc Graw-Hill, 1990, p 88-103.

Datas de Publicação

Publicação nesta coleção
20 Jan 2011
Data do Fascículo
Jun 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Armstrong D, Wong B. Central nervous system infection in immunocompromised hosts.Annu Rev Med 1982, 33: 293-308.

[2] 2. Beaman B, Burnside J, Edwards B, Causey W. Nocardial infection in the United States 1972-1974. J Infect Dis 1976, 134: 286-289.

[3] 3. Byrne E, Brophy BP, Pettet LV. Nocardia cerebral abscess: new concepts in diagnosis, management and prognosis. J Neurol Neurosurg Psychiatry 1979, 48: 1038-1045.

[4] 4. Coker RJ, Bignardi G, Homer P, Savage M, Cook T, Tomlinson D, Weber J. Nocardia infection in AIDS: a clinical and microbiological challenge. J Clin Pathol 1992, 45: 821-822.

[5] 5. Filice GA, Simpson GL: Management of Nocardia infection. Curr Clin Trap Infect Dis 1984, 5: 49-64.

[6] 6. Frazier AR, Rosenow EC III, Roberts GD. Nocardiosis: a review of 25 cases ocurring during 24 months. Mayo Clin Proc 1975, 50: 657-663,

[7] 7. Gilligan BS, Williams L. Nocardial meningitis: report of a case with bacteriological studies. Med J Aust 1962,2: 747-752.

[8] 8. Kirmani N, Tuazon CU, Oclin JA, Thompson AM, Kramer NC, Geelhoed GW. Extensive cerebral nocardiosis cured with antibiotic therapy alone. J Neurosurg 1978, 49: 924-928.

[9] 9. Krueger EG, Norsa L, Kenney M, Price PA. Nocardiosis of the central nervous system. J Neurosurg 1954, 11: 226-233.

[10] 10. Lee C, Dorman DC, Bradhurst PG. Disseminated nocardiosis: an acute fatal episode in a young girl. Aust Med J 1963, 2: 536-541.

[11] 11. Mandell W, Neu HC. Nocardial infections. In Vinken PJ, Bruyn GW, Klawans HL (eds). Handbook of clinical neurology, vol 52 (Microbial Disease). Amsterdam: Elsevier, 1988, p 445-453.

[12] 12. Norden CW, Ruben FL, Selker R. Nonsurgical treatment of cerebral nocardiosis. Arch Neurol 1983, 40: 594-595.

[13] 13. Pizzolato P, Ziskind J, Derman H, Buff EE. Nocardiosis of the brain: report of three cases. Am J Clin Pathol 1961, 36: 151-156.

[14] 14. Rosenblum ML, Rosegay A. Resection of multiple nocardial brain abscesses : diagnostic role of computadorized tomography. Neurosurgery 1979 , 4: 315-318.

[15] 15. Simpson GL, Stinson EB, Egger MJ, Remington JS. Nocardial infections in the immunocompromised host: a detailed study in a defined population. Rev Infect Dis 1981, 3: 492-507.

[16] 16. Smego RA Jr, Gallis HA. The clinical spectrum of nocardia brasiliensis infection in the United States. Rev Infect Dis 1981,6: 164-180.

[17] 17. Smego RA Jr, Moeller MB, Gallis HA. Trimethoprim-sulfamethoxazole therapy of Nocardia infections. Arch Intern Med 1983, 143: 711-718.

[18] 18. Smith PW, Steinkraus GE, Henricks BW, Madson EC. CNS nocardiosis: response to sulfamethoxazole therapy of Nocardia infections. Arch Neurol 1980, 37: 729-730.

[19] 19. Teleghani-Far M, Barber JB, Simpson C, Harden KA. Cerebral nocardiosis and alveolar proteinosis. Am Rev Respir Dis 1964 , 89: 561-565.

[20] 20. Turner E, Whitby JW. Nocardial cerebral abscess with systemic involvement successfully treated by aspiration and sulfonamides: case report. J Neurosurg 1969 , 31: 227-229.

[21] 21. Viroslav J, Williams TW Jr. Nocardial infection of the pulmonary and central nervous system: successful treatment with medical therapy. South Med J 1971, 64: 1382-1385.

[22] 22. Zimmerman RA. Magnetic resonance imaging of intracranial infections. In Wilkins RH, Rengachary SS (eds). Neurosurgery update: I. Diagnosis, operative technique, and neuro-oncology. New York: Mc Graw-Hill, 1990, p 88-103.

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Abscesso cerebelar por Nocardia: relato de caso

Cerebellar abscess by Nocardia: case report

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Datas de Publicação