Bacteremia and adrenal gland abscess due to Nocardia cyriacigeorgica: a case report and review

BackgroundNocardia cyriacigeorgica is one of the most common Nocardia species found in human infections, recently reclassified. Even though Nocardia may affect all organs by hematogenous dissemination, bacteremia are uncommon. Among all possible dissemination sites, the involvement of the adrenal glands is particularly rare. Case presentationWe report here a rare case of Nocardia disseminated infection with notably bacteremia and adrenal gland abscess, in a 77-years-old immunocompetent man. Adrenal gland abscess diagnosis was made by imaging (computerized tomography, magnetic resonance and positron emission tomography scan). A complete regression of all lesions including the left adrenal gland was obtained after 6 months of antibiotics. A review of literature was also performed. ConclusionNocardia bacteremia is a rare event but blood cultures may help to improve detection of Nocardia spp. in a non-invasive way. Adrenal abscess due to Nocardia spp. is very rare with only fourteen cases reported in the literature, but it is a true cause of adrenal masses. Our report suggests that clinician should be aware of this rare location and prioritize a non-invasive diagnosis strategy.

Automated summary

This article reports a rare case of disseminated Nocardia infection with bacteremia and adrenal gland abscess in a 77-year-old immunocompetent man. After 6 months of antibiotic treatment, all lesions completely regressed. This case highlights the need for clinicians to be aware of this rare location and prioritize a non-invasive diagnostic strategy.