{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:18:13Z","timestamp":1789269493045,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002377"],"award-info":[{"award-number":["UL1 TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Nocardia<\/jats:italic>\n                      frequently disseminates to the central nervous system (CNS). Few studies have described brain imaging characteristics of these infections or compared findings of computed tomography (CT) and magnetic resonance imaging (MRI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults diagnosed with CNS nocardiosis between November 2011 and April 2022 and underwent brain MRI. We aimed to describe common brain imaging characteristics, compare the diagnostic yield of brain CT and MRI, and describe clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      52 patients were diagnosed with CNS nocardiosis, of which 26 also underwent brain CT. Most patients (N\u2009=\u200943; 82.7%) were receiving immunosuppressing medication, had concurrent pulmonary involvement (N\u2009=\u200945; 86.5%), and the most common species was\n                      <jats:italic>N. farcinica<\/jats:italic>\n                      (N\u2009=\u200919; 36.5%). 50% had CNS symptoms. The most common radiographic characteristics were supratentorial involvement (N\u2009=\u200950; 96.2%), multiple lesions (N\u2009=\u200931; 59.6%), and bihemispheric involvement (N\u2009=\u200930; 57.7%). Of 26 with both imaging modalities, 5 (19.2%) did not have signs of CNS nocardiosis on CT. These patients had smaller CNS lesions (median 0.6 versus 1.8 cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and more often had multiple brain lesions or bihemispheric involvement (both: 100% versus 47.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.053). Twelve (23.1%) patients died within 12 months of diagnosis, though abnormal CT and CNS lesion\u2009\u2265\u20091 cm were not associated with mortality. Of 33 who completed therapy, 3 (9.1%) and 2 (6.1%) patients had residual neurologic deficits or post-treatment recurrence, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CNS nocardiosis commonly presents with multiple, supratentorial brain lesions. About 20% of patients will have a normal brain CT, usually those with multiple small lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02792-0","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:15:07Z","timestamp":1776172507000},"page":"1519-1527","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Imaging characteristics, yield of computed tomography, and clinical outcomes of central nervous system nocardiosis"],"prefix":"10.1007","volume":"54","author":[{"given":"Zachary A.","family":"Yetmar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan B.","family":"Khodadadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supavit","family":"Chesdachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack W.","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas W.","family":"Challener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy L.","family":"Wengenack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason T.","family":"Little","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendelyn","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Seville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Beam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"2792_CR1","doi-asserted-by":"crossref","unstructured":"Yetmar Z, Khodadadi R, Chesdachai S, et al.(2023) Mortality after Nocardiosis: Risk Factors and Evaluation of Disseminated Infection. Open Forum Infectious Diseases","DOI":"10.1093\/ofid\/ofad409"},{"key":"2792_CR2","doi-asserted-by":"publisher","first-page":"e01890","DOI":"10.1128\/aac.01890-21","volume":"66","author":"A Takamatsu","year":"2022","unstructured":"Takamatsu A, Yaguchi T, Tagashira Y, Watanabe A, Honda H. Nocardiosis in Japan: a Multicentric Retrospective Cohort Study. Antimicrob Agents Chemother. 2022;66:e01890-e1921.","journal-title":"Antimicrob Agents Chemother"},{"key":"2792_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jinf.2022.05.029","volume":"85","author":"S Soueges","year":"2022","unstructured":"Soueges S, Bouiller K, Botelho-Nevers E, et al. Prognosis and factors associated with disseminated nocardiosis: a ten-year harmacodyn study. J Infect. 2022;85:130\u20136.","journal-title":"J Infect"},{"key":"2792_CR4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1093\/cid\/ciab866","volume":"75","author":"D Averbuch","year":"2022","unstructured":"Averbuch D, De Greef J, Dur\u00e9ault A, et al. Nocardia Infections in Hematopoietic Cell Transplant Recipients: A Multicenter International Retrospective Study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. Clin Infect Dis. 2022;75:88\u201397.","journal-title":"Clin Infect Dis"},{"key":"2792_CR5","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1093\/cid\/ciw241","volume":"63","author":"J Coussement","year":"2016","unstructured":"Coussement J, Lebeaux D, Van Delden C, et al. Nocardia Infection in Solid Organ Transplant Recipients: A Multicenter European Case-control Study. Clin Infect Dis. 2016;63:338\u201345.","journal-title":"Clin Infect Dis"},{"key":"2792_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/ctr.13509","volume":"33","author":"A Restrepo","year":"2019","unstructured":"Restrepo A, Clark NM. Nocardia infections in solid organ transplantation: guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation. Clin Transplant. 2019;33:1\u201312.","journal-title":"Clin Transplant"},{"key":"2792_CR7","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/j.cmi.2020.12.019","volume":"27","author":"I Margalit","year":"2021","unstructured":"Margalit I, Lebeaux D, Tishler O, et al. How do I manage nocardiosis? Clin Microbiol Infect. 2021;27:550\u20138.","journal-title":"Clin Microbiol Infect"},{"key":"2792_CR8","doi-asserted-by":"publisher","first-page":"e53","DOI":"10.1093\/cid\/ciae643","volume":"80","author":"ZA Yetmar","year":"2025","unstructured":"Yetmar ZA, Marty PK, Clement J, Miranda C, Wengenack NL, Beam E. State-of-the-art review: modern approach to nocardiosis\u2014diagnosis, management, and uncertainties. Clin Infect Dis. 2025;80:e53\u201364.","journal-title":"Clin Infect Dis"},{"key":"2792_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab067\/6214531","author":"C Corsini Campioli","year":"2021","unstructured":"Corsini Campioli C, Castillo Almeida NE, O\u2019Horo JC, et al. Clinical Presentation, Management, and Outcomes of Patients With Brain Abscess due to Nocardia Species. Open Forum Infect Dis. 2021. https:\/\/doi.org\/10.1093\/ofid\/ofab067\/6214531.","journal-title":"Open Forum Infect Dis"},{"key":"2792_CR10","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377\u201381.","journal-title":"J Biomed Inform"},{"key":"2792_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","volume":"95","author":"PA Harris","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208.","journal-title":"J Biomed Inform"},{"key":"2792_CR12","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1148\/rg.2015140297","volume":"35","author":"JE Villanueva-Meyer","year":"2015","unstructured":"Villanueva-Meyer JE, Cha S. From shades of gray to microbiologic imaging: a historical review of brain abscess imaging: RSNA centennial article. Radiographics. 2015;35:1555\u201362.","journal-title":"Radiographics"},{"key":"2792_CR13","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1148\/rg.272065155","volume":"27","author":"JG Smirniotopoulos","year":"2007","unstructured":"Smirniotopoulos JG, Murphy FM, Rushing EJ, Rees JH, Schroeder JW. Patterns of contrast enhancement in the brain and meninges. Radiographics. 2007;27:525\u201351.","journal-title":"Radiographics"},{"key":"2792_CR14","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1148\/rg.2015140317","volume":"35","author":"RY Shih","year":"2015","unstructured":"Shih RY, Koeller KK. Bacterial, fungal, and parasitic infections of the central nervous system: radiologic-pathologic correlation and historical perspectives: from the Radiologic Pathology Archives. Radiographics. 2015;35:1141\u201369.","journal-title":"Radiographics"},{"key":"2792_CR15","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.3174\/ajnr.A2986","volume":"33","author":"CH Toh","year":"2012","unstructured":"Toh CH, Wei K-C, Chang C-N, et al. Differentiation of pyogenic brain abscesses from necrotic glioblastomas with use of susceptibility-weighted imaging. AJNR Am J Neuroradiol. 2012;33:1534\u20138.","journal-title":"AJNR Am J Neuroradiol"},{"key":"2792_CR16","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1007\/s00234-025-03588-z","volume":"67","author":"K Weger","year":"2025","unstructured":"Weger K, Carr C, Silvera VM, et al. Patterns of abnormal magnetic susceptibility in the brain: an image-based review. Neuroradiology. 2025;67:799\u2013822.","journal-title":"Neuroradiology"},{"key":"2792_CR17","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1159\/000525509","volume":"31","author":"DS Meena","year":"2022","unstructured":"Meena DS, Kumar D, Bohra GK, Midha N, Garg MK. Clinical characteristics and treatment outcome of central nervous system nocardiosis: a systematic review of reported cases. Med Princ Pract. 2022;31:333\u201341.","journal-title":"Med Princ Pract"},{"key":"2792_CR18","doi-asserted-by":"crossref","unstructured":"Chirila RM, Harris D, Gupta V, et al. Clinical and Radiological Characterization of Central Nervous System Involvement in Nocardiosis: A 20-Year Experience. Cureus 2024; Available at: https:\/\/www.cureus.com\/articles\/211290-clinical-and-radiological-characterization-of-central-nervous-system-involvement-in-nocardiosis-a-20-year-experience. Accessed 6 January 2026.","DOI":"10.7759\/cureus.52950"},{"key":"2792_CR19","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200134","volume":"13","author":"SC LaHue","year":"2023","unstructured":"LaHue SC, Guterman EL, Mikhail M, Li Y, Cha S, Richie MB. Clinical and radiographic characteristics of Nocardia vs non-Nocardia brain abscesses. Neur Clin Pract. 2023;13:e200134.","journal-title":"Neur Clin Pract"},{"key":"2792_CR20","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1016\/j.amjmed.2021.05.027","volume":"134","author":"C Corsini Campioli","year":"2021","unstructured":"Corsini Campioli C, Castillo Almeida NE, O\u2019Horo JC, et al. Bacterial brain abscess: an outline for diagnosis and management. Am J Med. 2021;134:1210-1217.e2.","journal-title":"Am J Med"},{"key":"2792_CR21","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/00004728-199501000-00003","volume":"19","author":"SD LeBlang","year":"1995","unstructured":"LeBlang SD, Whiteman ML, Post MJ, Uttamchandani RB, Bell MD, Smirniotopolous JG. CNS Nocardia in AIDS patients: CT and MRI with pathologic correlation. J Comput Assist Tomogr. 1995;19:15\u201322.","journal-title":"J Comput Assist Tomogr"},{"key":"2792_CR22","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11121843","volume":"11","author":"N Haddad","year":"2022","unstructured":"Haddad N, Carr M, Balian S, et al. The blood\u2013brain barrier and pharmacokinetic\/harmacodynamics optimization of antibiotics for the treatment of central nervous system infections in adults. Antibiotics Basel. 2022;11:1843.","journal-title":"Antibiotics Basel"},{"key":"2792_CR23","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1007\/s15010-024-02445-0","volume":"53","author":"NH Attias","year":"2025","unstructured":"Attias NH, Schlaeffer-Yosef T, Zahavi I, et al. Shorter vs. standard-duration antibiotic therapy for nocardiosis: a multi-center retrospective cohort study. Infection. 2025;53:1115\u201327.","journal-title":"Infection"},{"key":"2792_CR24","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae122","volume":"11","author":"ZA Yetmar","year":"2024","unstructured":"Yetmar ZA, Khodadadi RB, Chesdachai S, et al. Epidemiology, timing, and secondary prophylaxis of recurrent nocardiosis. Open Forum Infect Dis. 2024;11:ofae122.","journal-title":"Open Forum Infect Dis"},{"key":"2792_CR25","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13753","author":"ZA Yetmar","year":"2021","unstructured":"Yetmar ZA, Wilson JW, Beam E. Recurrent nocardiosis in solid organ transplant recipients: an evaluation of secondary prophylaxis. Transplant Infect Dis. 2021. https:\/\/doi.org\/10.1111\/tid.13753. (Accessed 27 May 2023).","journal-title":"Transplant Infect Dis"},{"key":"2792_CR26","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1093\/cid\/cix124","volume":"64","author":"D Lebeaux","year":"2017","unstructured":"Lebeaux D, Freund R, Van Delden C, et al. Outcome and treatment of nocardiosis after solid organ transplantation: new insights from a European study. Clin Infect Dis. 2017;64:1396\u2013405.","journal-title":"Clin Infect Dis"},{"key":"2792_CR27","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1097\/TP.0000000000004343","volume":"107","author":"ZA Yetmar","year":"2023","unstructured":"Yetmar ZA, Challener DW, Seville MT, Bosch W, Beam E. Outcomes of nocardiosis and treatment of disseminated infection in solid organ transplant recipients. Transplantation. 2023;107:782\u201391.","journal-title":"Transplantation"},{"key":"2792_CR28","doi-asserted-by":"publisher","first-page":"ofag008","DOI":"10.1093\/ofid\/ofag008","volume":"13","author":"M Vega Brizneda","year":"2025","unstructured":"Vega Brizneda M, Miranda C, Cober E, Misra A, Harrington S, Yetmar ZA. Risk factors and outcomes of disseminated nocardiosis across host risk groups. Open Forum Infect Dis. 2025;13:ofag008.","journal-title":"Open Forum Infect Dis"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02792-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02792-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02792-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:50:41Z","timestamp":1782921041000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02792-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["2792"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02792-0","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"assertion":[{"value":"16 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}