engleski

Nocardial brain abscesses and meningitis in a boy with systemic lupus erythematodes (SLE)

Nocardiosis is an opportunistic infection associated with systemic lupus erythematodes (SLE). Lung involvement is the most common site of infection, while central nervous system is less common and are mostly due to haematogenous spread. We present a 13 year-old boy with SLE complicated with primary multiple nocardial brain abscesses associated with meningitis which is extremely rare, especially in childhood. Three days after we started therapy with pulse doses of steroids, the patient presented with haedache, seizures, diplopias, paresis of the right abducens nerve and anisocoria. CT of the brain showed multiple abscesses. The first stereotactic biopsy of the abscess showed no diagnostic features, but the repeated stereotactic biopsy after 3 weeks revealed the presence of Nocardia spp. Owing to severe sideffects to trimethroprim/sulfamethoxazole and linezolid, the patient was treated successfully with imipenem only. The complete resolution of brain abscess and meningitis followed after two months of therapy. The relapse did not occur after 10 months of follow-up and SLE went into complete remission

Nocardiosis; SLE; brain abscesses

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