First isolation of Nocardia transvalensis in the Czech Republic from a brain abscess of a kidney transplant recipient
Abstract
A 66-year-old man with type 2 diabetes and chronic renal insufficiency underwent a second kidney transplantation after kidney graft failure due to chronic glomerulonephritis. Fourteen months after transplantation, a CT scan revealed multiple cerebral abscesses in the right frontal cerebral lobe.
Aerobic culture yielded filamentous gram-positive bacteria presumptively identified as the Nocardia transvalensis complex, based on their resistance to amikacin. The bacterium was confirmed by partial sequencing of the 16S rRNA and rpoB genes as N.transvalensis.
The patient was treated with the combination of intravenous meropenem and oral co-trimoxazole and anti-edema therapy. After 11 weeks, the patient was discharged to home care in good clinical condition with complete regression of neurological symptoms.
N. transvalensis is rarely detected in clinical specimens.This is the first report of N. transvalensis isolate in the Czech Republic.