Resumen
La nocardiosis es una infección localizada o diseminada causada por un microorganismo aeróbico. En el sistema nervioso central (SNC) es poco común, sólo 2% de todos los abscesos cerebrales. Usualmente afecta a los pacientes inmunocomprometidos y es muy rara en los inmunocompetentes. En ambos causa una morbimortalidad significativa. No hay un tratamiento ideal; la cirugía desempeña un papel importante, ya que facilita el diagnóstico bacteriológico y en ocasiones alivia la presión intracraneana.
Se presenta un paciente de 58 años con cefalea intensa y hemiparesia. El estudio de resonancia magnética demostró múltiples lesiones cerebrales. Se hicieron estudios de extensión para metástasis cerebrales, pero todos fueron negativos. Se efectuó una biopsia cerebral esterotáxica, negativa para malignidad en los cultivos creció una Nocardia spp. El manejo antibiótico ocasionó mejoría clínica significativa y a los 18 meses post-tratamiento el paciente está asintomático.
Citas
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