Revista de SIDA e investigación clínica

Pediatric Nocardial Brain Abscesses in Acquired Immunodeficiency Syndrome

Abstract

Chotey NA, Ramdial PK, Miles E, Nargan K and Mubaiwa L

Nocardiosis is relatively uncommon in children and adults with acquired immunodeficiency syndrome (AIDS), despite the profound associated cellular immunodeficiency. Acquired most often by inhalation and less commonly by percutaneous inoculation, subsequent hematogenous dissemination may lead to infection of almost any organ, with a particular predilection for the central nervous system. Nocardial brain abscesses are rare. To the best of our knowledge, pediatric Nocardial brain abscesses have not been documented in Human Immunodeficiency Virus (HIV)-infected children in the English-language literature, to date. In reporting two Nocardial brain abscesses in a 9 year old AIDS patient with intermittent seizures, we highlight the difficulty associated with the ante-mortem diagnosis of Nocardial brain abscesses, and the need for cognizance of rare entities occurring in HIV-infected children. Furthermore, we emphasize the pivotal role of the autopsy in finalizing the nature of the cerebral pathology, the cause of the seizures albeit post-mortem, a cause of death and in providing a platform for continued learning in the AIDS era.