Nocardia Ventriculitis: A Rare Case Report

Ventriculitis caused by Nocardia spp. is a rare infection of the central nervous system. To our knowledge, this is the first reported case of ventriculitis caused by Nocardia otitidiscaviarum. We present a 64-year-old woman admitted with confusion and malaise. Neuroimaging revealed marked enlargement and contrast enhancement of the left choroid plexus, suggestive of ventriculitis. Culture from surgical drainage confirmed N. otitidiscaviarum. Empirical antibiotic therapy, including trimethoprim-sulfamethoxazole, was initiated and later adjusted based on susceptibility testing results. However, during follow-up, the patient died from septic shock due to Klebsiella pneumoniae bacteremia. Nocardia-associated ventriculitis has a high mortality rate. Early diagnosis, timely surgical intervention, and appropriate antibiotics are essential for improving clinical outcomes.