If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
A 34-year-old man with AIDS presented with progressive slurred speech and general weakness for 2 months. His CD4 count was 29 cells/µL and viral load 407 copies/mL. Physical examination revealed clear consciousness, and meningeal signs were negative. Brain magnetic resonance imaging with contrast (Figure 1) revealed multiple thick ring enhanced lesions over bilateral cerebral, cerebellar hemispheres and brain stem. The tissue was obtained via craniotomy. Gram staining revealed scattered, weak gram-positive, curved rods (Figure 2). Modified acid-fast staining showed numerous tree-like organisms (Figure 3). The tissue culture yielded Nocardia beijingensis, which was confirmed by 16S ribosomal RNA sequencing. He was treated with sulfamethoxazole/trimethoprim and returned to his work without any neurological sequelae 1 year later.
Figure 1Sagittal view of T1 fluid-attenuated inversion recovery imaging with gadolinium showing multiple ring-enhanced lesions over the bilateral cerebral and cerebellar hemispheres and brain stem
). Magnetic resonance imaging frequently showed multiple cystic lesions surrounded by hypointensity on T2-weighted imaging with a multiloculated pattern after gadolinium chelate administration on T1-weighted imaging (
01236-4&id=gr1.jpg){kind=link}
01236-4&id=gr2.jpg){kind=link}
01236-4&id=gr3.jpg){kind=link}