A 55-year old man presented with a two-day history of headache, fever and generalized weakness. He had received a cadaveric kidney transplant 5 years earlier. His medications included 5 mg oftacrolimus twice a day and 10 mg of prednisone daily. On neurologic examination, he was confused and incoherent. Cranial nerves were normal, but he had a hazy left retina. Magnetic resonance imaging of the brain with the administration of gadolinium showed multiple enhancing lesion in both cerebral hemispheres. Patient had subretinal abscess, the aspirate was stained, the findings are liekly to be -
High-Yield Explanation
Nocardia species are classically gram-positive, strictly aerobic, filamentous, branching, weakly acid-fast bacilli. They may be isolated on routine bacterial, fungal, and mycobacterial media. Colonies may appear within 4 days, but may require up to 2-4 weeks of culture Nocardiosis is an infectious disease affecting either the lungs (pulmonary nocardiosis) or the whole body (systemic nocardiosis). It is due to infection by a bacterium of the genus Nocardia, most commonly Nocardia asteroides or Nocardia brasiliensis. Ref Davidson 23rd edition pg 714