Cerebral Nocardia Infections Following Lung Abscesses in a Kidney Transplant Recipient: A Case Report and Literature Review

Background

Bacterial, viral, and fungal infections are common following human kidney transplantation due to non-specific immunosuppressive therapy. Nocardiosis, though not common, is an important cause of morbidity and mortality among renal transplant recipients.

Case Report

We present a typical case from our region of multiple brain abscesses caused by Nocardia farcinica, along with a discussion of its diagnosis and treatment. A brain MRI of a 60-year-old Uyghur man, who had been on long-term immunosuppressive therapy, confirmed multiple brain abscesses. He was diagnosed with cerebral nocardiosis, which was considered to have originated from lung abscesses. Neurosurgery was performed to remove the abscesses. A 2-stage antibiotic regimen was implemented: intensive therapy with TMP-SMX and meropenem for the first 8 weeks, followed by consolidation therapy with TMP-SMX alone for the next 4 months.

Results

After a series of surgical and medical treatments, the patient achieved disease control and remained symptom-free during follow-up.

Conclusions

This case contributes to the understanding of multiple nocardia infections in immunosuppressed patients. It highlights the importance of appropriate diagnosis, timely surgical intervention, and effective antibiotic treatment in managing disseminated nocardiosis.