Distinguishing between an infective and malignant process provides a diagnostic challenge for clinicians. This case highlights an example of an acute spinal cord compression that could fall into either of these two categories. The diagnosis in this case of disseminated Nocardiosis is an extremely rare cause of acute spinal cord compression and to our knowledge intrinsic conus medullaris infection from Nocardia has not previously been reported in the literature. Nocardia cyriacigeorgica is an emerging strain of Nocardia species recently identified which was previously categorised as Nocardia asteroides type VI infection. The challenge of eliciting the diagnosis and the need to have an index of suspicion of Nocardia as a possible aetiology agent is shown in the report. The case shows this is especially important in evaluation of a multi-system infection in an immunosuppressed individual. The case described highlights an interesting diagnostic case with the resultant causative organism an emerging strain of Nocardia species with no previous reported cases of conus medullaris involvement
Keywords : Aged,Anti-Bacterial Agents,Cauda Equina,complications,diagnosis,Diagnosis,Differential,drug therapy,Female,Humans,Infection,microbiology,Nerve Compression Syndromes,Nocardia Infections,Opportunistic Infections,pathology,Polyradiculopathy,Spinal Cord,Spinal Cord Compression,Spinal Cord Neoplasms,therapeutic use,Treatment Outcome,Victoria,, Spinal,Cord,Compression,Caused,By, generic butrans patch
Date of Publication : 2010 Oct
Authors : Stokes MB;Reardon KA;O’Day J;
Organisation : St Vincent’s Health, Victoria, Australia. mstoker89@hotmail.com
Journal of Publication : Clin Neurol Neurosurg
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20646828
The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery
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