Journal of Medical Case Reports最新文献

{"title":"Bilateral Aspergillus endophthalmitis following cataract surgery: a diagnostic and therapeutic challenge-a case report.","authors":"Mohammadkarim Johari, Mostafa Abuali, Seyed Ahmad Razavizadegan, Mehdi Moallem","doi":"10.1186/s13256-025-05373-1","DOIUrl":"10.1186/s13256-025-05373-1","url":null,"abstract":"<p><strong>Background: </strong>Here we describe a case of bilateral Aspergillus endophthalmitis occurring 4 months after bilateral cataract surgery, manifesting as a spectacular filamentary branching on the intraocular lens/capsular surface and difficulties in treatment.</p><p><strong>Case presentation: </strong>A 66-year-old Iranian male patient with a known case of chronic lymphocytic leukemia, who had previously undergone bilateral cataract surgery during the same session 4 months before, presented with a bilateral decrease in vision and vitreous haziness. The cytopathology results from vitreous sampling were negative for dysplastic cells. Still, the polymerase chain reaction analysis showed a positive result for Aspergillus sp., and a unique, striking filamentary branching growth appeared on the intraocular lens/capsular surface in both eyes. Treatment was challenging, with multiple vitrectomies and systemic and intravitreal anti-fungal agent treatment.</p><p><strong>Conclusion: </strong>Challenges in managing bilateral Aspergillus endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"307"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality imaging techniques of diaphragmatic ectopic pregnancy: a case report and review of the literature.","authors":"Cong Liu, Guangshuai Huang, Cunzhi Zhu, Meiling Ji, Xiaoxue Yang, Yigen Peng","doi":"10.1186/s13256-025-05360-6","DOIUrl":"10.1186/s13256-025-05360-6","url":null,"abstract":"<p><strong>Background: </strong>Abdominal ectopic pregnancy is a rare form of ectopic pregnancy, and diaphragmatic ectopic pregnancy is even rarer. We described a case of an ectopic pregnancy implanted on the diaphragm's surface, diagnosed using multimodality imaging techniques, including ultrasonography, X-ray computed tomography, and magnetic resonance imaging.</p><p><strong>Case presentation: </strong>A 39-year-old Han Chinese female presented with abdominal pain and was diagnosed with subcapsular hemorrhage of the liver on the basis of computed tomography imaging. The patient had experienced paroxysmal severe pain in the right abdomen, without any history of trauma, vomiting, or diarrhea. Her vital signs were stable, and she did not exhibit signs of hemorrhagic shock. She reported that her last menstrual period ended 13 days before the onset of symptoms and that she had a regular menstrual cycle. However, her blood human chorionic gonadotropin levels were significantly elevated. Based on multimodality imaging techniques, including ultrasonography, computed tomography, and magnetic resonance imaging, ectopic pregnancy was considered as a possible diagnosis. To further investigate, laparoscopic exploration was performed. During the procedure, minimal adherent tissue and a small clot were found on the diaphragm's surface. Histological examination confirmed the clot to be a mixture of chorion and blood. The patient remained stable postoperatively and was discharged 1 week after surgery.</p><p><strong>Conclusion: </strong>Using multimodality imaging techniques for diagnosis prior to treatment is of great significance for patients with ectopic pregnancy with atypical clinical presentations. These techniques enable clear delineation of tissue planes, thereby facilitating accurate diagnosis and preoperative planning by the surgical team.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"311"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right lower limb lymphatic aplasia in lymphoscintigraphy: a case report.","authors":"Prayash Paudel, Neetika Paudel, Manish Timalsina","doi":"10.1186/s13256-025-05374-0","DOIUrl":"10.1186/s13256-025-05374-0","url":null,"abstract":"<p><strong>Background: </strong>Primary lymphedema, affecting 1.15 per 100,000 individuals, under 20 years is rare. It includes three types: major vessel abnormalities, congenital lymphatic valvular incompetence or aplasia, and lymph node fibrosis. This condition arises from inherent lymphatic abnormalities and can be linked to genetic mutations causing valvular dysfunction, hypoplasia, or aplasia. Clinically, it can be isolated or syndromic and can present as Milroy's disease or Meige's disease depending on onset and associated features. Lymphoscintigraphy often reveals aplasia (14%) or hypoplasia (56%). In this case, lymphoscintigraphy indicated right lower limb aplasia correlating with clinical findings of limb swelling. This is one of the very few cases of lymphatic aplasia confirmed by lymphoscintigraphy. Management involves a multidisciplinary team approach, focusing on symptom control and patient education, as the condition is incurable but manageable.</p><p><strong>Case presentation: </strong>This is a case report of a 14-year-old boy from Southern Nepal with right limb swelling since birth and progressive scrotal and penile swelling for 7 years. Examination showed unilateral, painless non-pitting edema in the right leg, scrotum, and penile shaft. Imaging showed abdominal and left inguinal lymphadenopathy. Left inguinal lymph node biopsy indicated capillary hemangioma. Lymphoscintigraphy confirmed primary lymphatic aplasia with absent lymphatic channels in the right lower limb. Treatment focused on physiotherapy for symptom management, with regular monitoring.</p><p><strong>Conclusion: </strong>Diagnosis of primary lymphedema is necessary for timely intervention to halt the progression and prevent complications. The most sensitive method of diagnosis is lymphoscintigraphy, with its advantage over conventional methods.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"306"},"PeriodicalIF":0.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate hypothermia at 29.5 °C in a patient without neurocognitive alterations: a case report.","authors":"Arianna Merra, Luca Tagliabue, Adam-Scott Feiner","doi":"10.1186/s13256-025-05347-3","DOIUrl":"10.1186/s13256-025-05347-3","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia is typically associated with neurocognitive impairment, particularly as core temperature drops. However, cases without such symptoms are rarely reported. This case highlights an unusual presentation of moderate hypothermia without cognitive dysfunction, raising questions about individual variability in clinical manifestations.</p><p><strong>Case presentation: </strong>A Swiss Caucasian female patient in her early 50s with a known history of psychiatric disorders presented to the emergency department with a core body temperature of 29.5 °C, consistent with moderate hypothermia. Remarkably, she was alert, oriented, and exhibited no signs of neurocognitive impairment, such as confusion, memory loss, or altered mental status. Her vital signs were stable, and laboratory and imaging studies excluded common causes such as infection, intoxication, or endocrine dysfunction. She was treated with passive external rewarming and careful monitoring. Her clinical condition improved steadily, and she was discharged without complications or neurological deficits.</p><p><strong>Conclusion: </strong>This case demonstrates that moderate hypothermia may, in rare cases, present without neurocognitive alterations. It challenges the conventional association between hypothermia severity and mental status changes and suggests the need for further investigation into the physiological mechanisms behind this variability.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"293"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient perivascular inflammation of the carotid artery syndrome in a 52-year-old female patient: a case report.","authors":"Christos Dimopoulos, Sotirios Bisdas, Theodosios Bisdas","doi":"10.1186/s13256-025-05349-1","DOIUrl":"10.1186/s13256-025-05349-1","url":null,"abstract":"<p><strong>Background: </strong>Transient perivascular inflammation of the carotid artery syndrome is a rare and under-recognized clinical condition. It may mimic more serious vascular disorders such as carotid dissection or vasculitis, leading to unnecessary investigations or treatment. Recognition of this benign, self-limiting entity is essential to ensure appropriate management.</p><p><strong>Case presentation: </strong>We describe the case of a 52-year-old Caucasian Greek woman who presented with acute, well-localized pain on the left side of her neck, centered over the carotid artery and radiating toward the ipsilateral jaw. She had no systemic or neurological symptoms. Physical examination revealed focal tenderness over the left carotid bifurcation. Initial Doppler ultrasound raised suspicion of carotid artery dissection; however, magnetic resonance imaging demonstrated eccentric wall thickening and perivascular fat stranding without luminal narrowing or enhancement, findings consistent with transient perivascular inflammation of the carotid artery syndrome. The differential diagnosis included dissection, vasculitis, and lymphadenopathy, all excluded by clinical and imaging evaluation. The patient was managed conservatively with nonsteroidal antiinflammatory drugs, resulting in complete resolution of symptoms within 4 weeks. Follow-up magnetic resonance imaging at 6 months confirmed no recurrence.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering transient perivascular inflammation of the carotid artery syndrome in patients presenting with localized neck pain and suggestive imaging features. Accurate diagnosis can help avoid unnecessary interventions and promote effective, conservative treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"300"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute interstitial nephritis and probable Vogt-Koyanagi-Harada disease following COVID-19 infection: a case report.","authors":"Nahid Aslani, Mohammad Malekahmadi, Alireza Merrikhi, Alaleh Gheisari, Aida Mardani, Kimia Afshar","doi":"10.1186/s13256-025-05357-1","DOIUrl":"10.1186/s13256-025-05357-1","url":null,"abstract":"<p><strong>Introduction: </strong>Vogt-Koyanagi-Harada disease is an autoimmune inflammatory disease characterized by bilateral serous retinal detachment, which viral infections might induce. Coronavirus disease 2019 infection is thought to cause numerous autoimmune and inflammatory disorders. We report a case of Vogt-Koyanagi-Harada disease post-coronavirus disease 2019 infection in the pediatric population.</p><p><strong>Case presentation: </strong>A 9-year-old Iranian girl with positive severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction presented with an elevated serum creatinine level due to acute interstitial nephritis that was treated with a high dose of corticosteroid. During corticosteroid tapering, she complained of reduced visual acuity in her right eye. After evaluation and imaging, diagnosis of unilateral Vogt-Koyanagi-Harada disease was made, and the patient was successfully treated with high-dose corticosteroid, methotrexate, and antitumor necrosis factor α.</p><p><strong>Conclusion: </strong>Coronavirus disease 2019 infection could be a possible trigger factor for acute interstitial nephritis and Vogt-Koyanagi-Harada disease. Early diagnosis and treatment of these autoimmune features with corticosteroids and other antiinflammatory agents can help in faster improvement in these patients. In addition, it is crucial for physicians to consider Vogt-Koyanagi-Harada disease in pediatrics as one of the coronavirus disease 2019 complications for early diagnose and current treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"303"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic seizures and hyperhidrosis due to glioblastoma in a middle-aged man: a case report.","authors":"Khulood Alnuaimi, Preethi Asapu, Rafeef Tahtamoni, Resshme Sudha, David O Alao","doi":"10.1186/s13256-025-05375-z","DOIUrl":"10.1186/s13256-025-05375-z","url":null,"abstract":"<p><strong>Background: </strong>Hyperhidrosis is common. History, physical examination, and simple investigations are often sufficient to confirm the diagnosis. However, hyperhidrosis can result from focal autonomic seizures. Diagnosing focal autonomic seizures is challenging, and there is a high rate of misdiagnosis.</p><p><strong>Case presentation: </strong>A 59-year-old Emirati man presented with intermittent sweating episodes and fatigue of 3 weeks duration. Initial differential diagnoses included poorly controlled diabetes, hyperthyroidism, and cardiac arrhythmia. A focal autonomic seizure was suspected after visits to five different specialities. A diagnosis of temporal glioblastoma was confirmed on an magnetic resonance imaging scan. The patient had surgical removal of the tumor, and his symptoms resolved after treatment with levetiracetam and dexamethasone.</p><p><strong>Conclusion: </strong>Hyperhidrosis is common and can be easy to treat. However, hyperhidrosis may be a manifestation of focal autonomic seizure resulting from life-threatening conditions such as glioblastoma. Clinicians need to have a high index of suspicion when managing patients with excessive recurrent sweating.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"296"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin A injections and adverse effects to mimic muscle in TMD myofascial pain treatment: a case report.","authors":"Elina Alvesalo, Pentti Kemppainen, Olli Teronen, Antti Kämppi, Victoria Sitnikova","doi":"10.1186/s13256-025-05278-z","DOIUrl":"10.1186/s13256-025-05278-z","url":null,"abstract":"<p><strong>Background: </strong>Botulinum toxin A is an increasingly used drug in the treatment of temporomandibular disorders and chronic myofascial pain. Although the treatment is safe, and the procedure is fairly simple, adverse effects can occur. In this case report, we discuss a 37 -year-old, Finnish female patient in whom m. Risorius was temporarily paralyzed by botulinum toxin A injections. According to the study protocol the injections were applied bilaterally to the masseter and temporalis muscles. Represented adverse effects of botulinum toxin A injections are rare according to current literature and therefore it is important to bring this matter up especially from an educational point of view.</p><p><strong>Case presentation: </strong>This case report describes a case of a 37 -year-old, Finnish female patient who participated in a randomized clinical trial of botulinum toxin A in patients suffering from temporomandibular disorders, more detailed myalgia and headache attributed to temporomandibular disorders conducted in Helsinki University. The patient reported pain in the face area every day for the last 6 months (Diagnostic Criteria for Temporomandibular Disorders Axis II survey) before entering the study. She had had a night splint, more detailed a Michigan splint in the upper jaw, for 1 year and 3 months and had tried selfcare instructions, such as massage and movement therapies, as well as physical therapy with moderate success. Treatment modalities provided only temporary relief for the existing problem.</p><p><strong>Conclusion: </strong>Even though the patient experienced adverse effects (temporary paralysis of the m.Risorius) after the botulinum toxin A injections she also experienced a noticeable reduction in muscle pain and headache attributed to temporomandibular disorders after the injections and after 6 months still reported reduced pain in the head and neck area. (characteristic pain intensity and graded chronic pain scale values were lower than before the study). Although the paper indicates possible positive outcomes of botulinum toxin A injections for patients suffering from myalgia in mastication muscles and temporomandibular disorders associated headache, there are also adverse effects to consider before making any decision on botulinum toxin A injections.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"298"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crohn's disease onset associated with a ballistic injury to the abdomen in the patient wounded in the war in Ukraine: a case report.","authors":"Igor Lurin, Eduard Khoroshun, Vitalii Makarov, Volodymyr Nehoduiko, Serhii Shypilov, Stepan M Chobey, Maksym Gorobeiko, Andrii Dinets","doi":"10.1186/s13256-025-05333-9","DOIUrl":"10.1186/s13256-025-05333-9","url":null,"abstract":"<p><strong>Background: </strong>The Russo-Ukrainian war is ongoing warfare that is associated with severe injuries among the civil population and military personnel. The aim of this study was to demonstrate a rare case of Crohn's disease manifestation in a combat patient in relation to a ballistic injury to the abdomen in the ongoing war in Ukraine.</p><p><strong>Case presentation: </strong>A male Caucasian Ukrainian patient 34 years of age received a ballistic injury to the abdomen due to artillery shelling. During the next 22 days, the patient underwent bowel resections with anastomosis as well as several relaparotomies for abdomen revision and lavage. On the 23rd day, the patient was diagnosed with gastrointestinal bleeding. An esophagogastroduodenoscopy showed no signs of active bleeding, but longitudinal ulcers with a cobblestone appearance were detected, which is typical for Crohn's disease. Sulfasalazine at a dose of 3.0 g per day was prescribed to the patient. On the 25th day after the injury, the patient was diagnosed with intestinal bleeding and peritonitis, indicating perforation. At relaparotomy, a perforated ulcer 0.5 cm × 0.5 cm with even and well-defined borders was identified in the jejunum located 10 cm from the Treitz ligament. The ulcer was excised, and the intestine defect was sutured, followed by retrograde intubation of the jejunum. Until the 40th day after the injury, the patient underwent conservative treatment. The patient died on the 40th day after the injury due to multiple organ dysfunction syndrome, which was associated with respiratory failure (pneumonia) and severe intoxication.</p><p><strong>Conclusion: </strong>Ballistic injury to the abdomen might be a trigger for the onset of Crohn's disease. Patients with intestinal bleeding and stress ulcers should be evaluated for concomitant gastroenterological disorders, and appropriate clinical investigations and management should be applied.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"305"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated Nocardia species infection manifested with multiple brain abscesses and lung involvement in an immunocompetent patient: a case report.","authors":"Sepehr Omoomi, Sina Fadaei Tehrani, Farzin Khorvash, Abbas Ali Torfeh Esfahani","doi":"10.1186/s13256-025-05359-z","DOIUrl":"10.1186/s13256-025-05359-z","url":null,"abstract":"<p><strong>Background: </strong>Nocardia species are opportunistic pathogens typically transmitted through inhalation or direct skin contact, causing various clinical manifestations, particularly in immunocompromised individuals. Nocardia spp. infection with severe clinical manifestations is rare in immunocompetent patients. In immunocompetent patients, complicated clinical presentations-central nervous system involvement, including multiple large and encapsulated brain abscesses with vasogenic edema and countless miliary-like lesions involving the brain, cerebellum, and brain stem-are rare, and treatment with plain antibiotic therapy to complete remission is highly unlikely compared with the emphasized combined neurosurgical interventions.</p><p><strong>Case presentation: </strong>We presented the case of a 67-year-old Iranian male with Nocardia spp. infection, an immunocompetent patient with prolonged and insidious manifestation that involved lung and central nervous system with solitary mature and countless miliary-like brain abscesses. Treatment with high-dose parenteral trimethoprim-sulfamethoxazole and meropenem for 6 weeks, followed by oral trimethoprim-sulfamethoxazole, successfully managed the disease without requiring neurosurgical intervention despite clinical indications. A follow-up brain magnetic resonance imaging showed that treatment led to the shrinkage of brain lesions.</p><p><strong>Conclusion: </strong>We presented a case of Nocardia spp.-infection spp. infection in an immunocompetent patient with no significant history or comorbidities. The patient presented with a central nervous system infection characterized by solitary and miliary-like lesions. This case highlights the importance of considering Nocardia spp. infection as a differential diagnosis, particularly in patients with insidious and complex clinical manifestations. Meanwhile, it seems that more precise neurosurgical indications are necessary.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"304"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}