AUTHOR=Yang Jianhua , Xie Shuhua , Li Junda , Xia Han , Liu Xianghong 

TITLE=Brain Abscess Caused by Nocardia farcinica and Diagnosed by Metagenomic Next-Generation Sequencing: A Case Report

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.803554

DOI=10.3389/fmed.2022.803554

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>Brain abscesses caused by <italic>Nocardia farcinica</italic> are rare and difficult to diagnose. Conventional methods for diagnosing Nocardia species include blood culture, microscopy, and tissue slice, but the performance is not satisfied. We report a case of brain abscess due to <italic>N. farcinica</italic> diagnosed by metagenomic next-generation sequencing (mNGS).</p></sec><sec><title>Case Presentation</title><p>We report a case of a 58-year-old man with brain abscess caused by <italic>N. farcinica</italic>. The patient had a history of pemphigus and required long-term methylprednisolone administration. No pathogen was detected in blood culture, cerebrospinal fluid (CSF) culture, and fast-acid staining. mNGS identified <italic>N. farcinica</italic> in the CSF. The symptoms and signs of the patient were significantly improved after changing the antibiotics accordingly to sensitive antibiotics.</p></sec><sec><title>Conclusion</title><p>Metagenomic next-generation sequencing (mNGS) is helpful for early diagnosis and subsequent treatment of <italic>Nocardia</italic>-associated meningitis and encephalitis, avoiding brain surgery. Early and accurate diagnosis and prompt antibiotic treatment reduced its mortality.</p></sec>