Abstract
Nocardia is a Gram-positive, partially acid-fast, catalase-positive, and urease-positive bacterium that grows aerobically. We present an extremely rare case of cauda equina syndrome due to isolated intramedullary Nocardia farcinica infection. A 44-year-old male presented with low backache and gradually progressive weakness in bilateral lower limbs followed by paraplegia. He was found to have a well-defined, sharply demarcated ring-enhancing lesion located from T11-T12 to L3 vertebral body. He underwent laminectomy and decompression. The histopathological examination revealed a Gram-positive filamentous organism that looks like Nocardia. The culture report was suggestive of Nocardia farcinica. He was then treated with antibiotics and had a remarkable clinical and radiological improvement.
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Abbreviations
- CT scan:
-
Computed tomography scan
- MRI:
-
Magnetic resonance imaging
- ANCA:
-
Antineutrophil cytoplasmic antibody
- MPO:
-
Myeloperoxidase
- ANA:
-
Antinuclear antibody
- dsDNA:
-
Double-stranded deoxygenated nucleic acid
- ACE:
-
Angiotensin-converting enzyme
- ESR:
-
Erythrocyte sedimentation rate
- CRP:
-
C-reactive protein
- HBsAg:
-
Hepatitis B surface antigen
- DL spine:
-
Dorso-lumbar spine
- T1WI:
-
T1-weighted image
- T2WI:
-
T2-weighted image
- CSF:
-
Cerebrospinal fluid
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Acknowledgments
The authors would like to acknowledge the patient who agreed to be a part of this case study. Also, we would like to acknowledge our hospital’s academic department and library which helped us immensely with the research work.
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Chakraborty, T., Vyas, M., Goyal, A. et al. A rare case of isolated cauda equina Nocardia farcinica infection. J. Neurovirol. 26, 615–618 (2020). https://doi.org/10.1007/s13365-020-00863-y
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DOI: https://doi.org/10.1007/s13365-020-00863-y