CNS Nocardia in AIDS patients

CT and MRI with pathologic correlation

S. D. LeBlang, M. L H Whiteman, M. Judith Post, R. B. Uttamchandani, M. D. Bell, J. G. Smirniotopolous

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: Since CNS nocardiosis is an often fatal yet potentially treatable infection in HIV patients, we sought to identify and characterize imaging features that may suggest the diagnosis in the appropriate clinical setting. Materials and Methods: The CT scans (six), MR scans (one), or both (two) were evaluated in nine HIV patients with pathologically proven CNS Nocardia asteroides. Chest X-ray films were available in seven patients. Findings were correlated with pathologic examination. Results: All nine patients had brain abscesses, and in seven that received intravenous contrast agent, all lesions demonstrated ring enhancement. Five of nine patients had hydrocephalus and four of these had clinical evidence of meningitis. Small subependymal nodules were seen in five of nine patients and four of these also had meningitis. Pathologic examination in three of nine cases demonstrated a dense inflammatory infiltrate lining the ventricles that extended through the ependymal lining, producing small subependymal abscesses. Six of seven available chest X-ray films demonstrated infiltrates due to Nocardia. Conclusion: Our radiologic-pathologic correlation indicates that in an HIV-positive patient with enhancing parenchymal lesions, the additional findings of subependymal nodules and/or meningitis may suggest the diagnosis of nocardiosis. An associated pulmonary infiltrate can provide a clue to the diagnosis and serve as a more accessible site for biopsy or culture.

Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalJournal of Computer Assisted Tomography
Volume19
Issue number1
StatePublished - Jan 1 1995

Fingerprint

Nocardia
Acquired Immunodeficiency Syndrome
Meningitis
Nocardia Infections
X-Ray Film
Thorax
Nocardia asteroides
HIV
Brain Abscess
Hydrocephalus
Abscess
Contrast Media
HIV Infections
Biopsy
Lung

Keywords

  • Brain, abscess
  • Computed tomography
  • Magnetic resonance imaging
  • Meningitis
  • Nocardia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

LeBlang, S. D., Whiteman, M. L. H., Judith Post, M., Uttamchandani, R. B., Bell, M. D., & Smirniotopolous, J. G. (1995). CNS Nocardia in AIDS patients: CT and MRI with pathologic correlation. Journal of Computer Assisted Tomography, 19(1), 15-22.

CNS Nocardia in AIDS patients : CT and MRI with pathologic correlation. / LeBlang, S. D.; Whiteman, M. L H; Judith Post, M.; Uttamchandani, R. B.; Bell, M. D.; Smirniotopolous, J. G.

In: Journal of Computer Assisted Tomography, Vol. 19, No. 1, 01.01.1995, p. 15-22.

Research output: Contribution to journalArticle

LeBlang, SD, Whiteman, MLH, Judith Post, M, Uttamchandani, RB, Bell, MD & Smirniotopolous, JG 1995, 'CNS Nocardia in AIDS patients: CT and MRI with pathologic correlation', Journal of Computer Assisted Tomography, vol. 19, no. 1, pp. 15-22.
LeBlang SD, Whiteman MLH, Judith Post M, Uttamchandani RB, Bell MD, Smirniotopolous JG. CNS Nocardia in AIDS patients: CT and MRI with pathologic correlation. Journal of Computer Assisted Tomography. 1995 Jan 1;19(1):15-22.
LeBlang, S. D. ; Whiteman, M. L H ; Judith Post, M. ; Uttamchandani, R. B. ; Bell, M. D. ; Smirniotopolous, J. G. / CNS Nocardia in AIDS patients : CT and MRI with pathologic correlation. In: Journal of Computer Assisted Tomography. 1995 ; Vol. 19, No. 1. pp. 15-22.
@article{c2daad8fe466406cb2f1ba8960688071,
title = "CNS Nocardia in AIDS patients: CT and MRI with pathologic correlation",
abstract = "Objective: Since CNS nocardiosis is an often fatal yet potentially treatable infection in HIV patients, we sought to identify and characterize imaging features that may suggest the diagnosis in the appropriate clinical setting. Materials and Methods: The CT scans (six), MR scans (one), or both (two) were evaluated in nine HIV patients with pathologically proven CNS Nocardia asteroides. Chest X-ray films were available in seven patients. Findings were correlated with pathologic examination. Results: All nine patients had brain abscesses, and in seven that received intravenous contrast agent, all lesions demonstrated ring enhancement. Five of nine patients had hydrocephalus and four of these had clinical evidence of meningitis. Small subependymal nodules were seen in five of nine patients and four of these also had meningitis. Pathologic examination in three of nine cases demonstrated a dense inflammatory infiltrate lining the ventricles that extended through the ependymal lining, producing small subependymal abscesses. Six of seven available chest X-ray films demonstrated infiltrates due to Nocardia. Conclusion: Our radiologic-pathologic correlation indicates that in an HIV-positive patient with enhancing parenchymal lesions, the additional findings of subependymal nodules and/or meningitis may suggest the diagnosis of nocardiosis. An associated pulmonary infiltrate can provide a clue to the diagnosis and serve as a more accessible site for biopsy or culture.",
keywords = "Brain, abscess, Computed tomography, Magnetic resonance imaging, Meningitis, Nocardia",
author = "LeBlang, {S. D.} and Whiteman, {M. L H} and {Judith Post}, M. and Uttamchandani, {R. B.} and Bell, {M. D.} and Smirniotopolous, {J. G.}",
year = "1995",
month = "1",
day = "1",
language = "English",
volume = "19",
pages = "15--22",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - CNS Nocardia in AIDS patients

T2 - CT and MRI with pathologic correlation

AU - LeBlang, S. D.

AU - Whiteman, M. L H

AU - Judith Post, M.

AU - Uttamchandani, R. B.

AU - Bell, M. D.

AU - Smirniotopolous, J. G.

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Objective: Since CNS nocardiosis is an often fatal yet potentially treatable infection in HIV patients, we sought to identify and characterize imaging features that may suggest the diagnosis in the appropriate clinical setting. Materials and Methods: The CT scans (six), MR scans (one), or both (two) were evaluated in nine HIV patients with pathologically proven CNS Nocardia asteroides. Chest X-ray films were available in seven patients. Findings were correlated with pathologic examination. Results: All nine patients had brain abscesses, and in seven that received intravenous contrast agent, all lesions demonstrated ring enhancement. Five of nine patients had hydrocephalus and four of these had clinical evidence of meningitis. Small subependymal nodules were seen in five of nine patients and four of these also had meningitis. Pathologic examination in three of nine cases demonstrated a dense inflammatory infiltrate lining the ventricles that extended through the ependymal lining, producing small subependymal abscesses. Six of seven available chest X-ray films demonstrated infiltrates due to Nocardia. Conclusion: Our radiologic-pathologic correlation indicates that in an HIV-positive patient with enhancing parenchymal lesions, the additional findings of subependymal nodules and/or meningitis may suggest the diagnosis of nocardiosis. An associated pulmonary infiltrate can provide a clue to the diagnosis and serve as a more accessible site for biopsy or culture.

AB - Objective: Since CNS nocardiosis is an often fatal yet potentially treatable infection in HIV patients, we sought to identify and characterize imaging features that may suggest the diagnosis in the appropriate clinical setting. Materials and Methods: The CT scans (six), MR scans (one), or both (two) were evaluated in nine HIV patients with pathologically proven CNS Nocardia asteroides. Chest X-ray films were available in seven patients. Findings were correlated with pathologic examination. Results: All nine patients had brain abscesses, and in seven that received intravenous contrast agent, all lesions demonstrated ring enhancement. Five of nine patients had hydrocephalus and four of these had clinical evidence of meningitis. Small subependymal nodules were seen in five of nine patients and four of these also had meningitis. Pathologic examination in three of nine cases demonstrated a dense inflammatory infiltrate lining the ventricles that extended through the ependymal lining, producing small subependymal abscesses. Six of seven available chest X-ray films demonstrated infiltrates due to Nocardia. Conclusion: Our radiologic-pathologic correlation indicates that in an HIV-positive patient with enhancing parenchymal lesions, the additional findings of subependymal nodules and/or meningitis may suggest the diagnosis of nocardiosis. An associated pulmonary infiltrate can provide a clue to the diagnosis and serve as a more accessible site for biopsy or culture.

KW - Brain, abscess

KW - Computed tomography

KW - Magnetic resonance imaging

KW - Meningitis

KW - Nocardia

UR - http://www.scopus.com/inward/record.url?scp=0028813898&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028813898&partnerID=8YFLogxK

M3 - Article

VL - 19

SP - 15

EP - 22

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

IS - 1

ER -