Nocardiosis cerebral abscess in an HIV patient in Vietnam

 https://doi.org/10.52322/jocmbmh.08.en.06

Introduction: Nocardiosis is an uncommon infection caused by Nocardia bacteria. This infection previously discovered in HIV patients and later found in immunodeficiency cases (due to the long-term use of corticosteroid or immunosuppressants), and in patients with rheumatoid arthritis or severe gastroenteritis.

Objectives: We reported a case of cerebral abscess caused by Nocardia bacteria in a HIV patient under treatment at Bach Mai Hospital in Vietnam.

Case presenttation: The patient’s reason for admission was head aching. He was previously diagnosed with HIV infection and a brain abscess in the right frontal pole. The patient was non-responsive after one month of cerebral toxoplasmosis treatment and Cotrimoxazole treatment for HIV. Indications for surgery was adopted. He was then performed an abscess drainage procedure. Norcadia sp is found in bacterial culture test of abscess pus, and its antibiogram was sensitive to Sulfamethoxazole/Trimethoprim, Amikacin and resistant to Imipenem. The indicated treatment was Amikacin by 7.5 mg/kg per 12 hours and oral Cotrimoxazole. The patient responded well to the treatment, was discharged and follow-up by an HIV outpatient service

Conclusion: Central nervous system nocardiosis is a rare disease with a high rate of mortality. Our study might be useful for clinicians in the field of infectious diseases in Vietnam.

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