{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:33:13Z","timestamp":1769725993056,"version":"3.49.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Septic facet cysts are a rare phenomenon reported in the literature among immunocompromised hosts and may require operative intervention for appropriate source and symptomatic control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A 70-year-old male with a past medical history of immunoglobulin A lambda smoldering myeloma degenerative lumbar disease who presented with low back and radicular lower extremity pain was found to have a left L4\u20135 septic facet cyst with extension to the epidural space. Intraoperative cultures were positive for\n                      <jats:italic>Nocardia<\/jats:italic>\n                      species. Staging workup revealed progression to high-risk-profile multiple myeloma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>\n                      Patients with septic facet cysts may require operative intervention for appropriate source control.\n                      <jats:italic>Nocardia<\/jats:italic>\n                      spine infections and septic facet cysts are rare and require investigation of preexisting risk factors and any potential underlying immunocompromise.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25220\">https:\/\/thejns.org\/doi\/10.3171\/CASE25220<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25220","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:26:44Z","timestamp":1758587204000},"source":"Crossref","is-referenced-by-count":0,"title":["Nocardia facet sepsis, an indicator of immunocompromise: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Meera","family":"Dhodapkar","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Rosenow","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles-Antoine","family":"Mechas","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"8","key":"bib1","series-title":"Spine (Phila Pa 1976)","first-page":"874","article-title":"Synovial cysts of the lumbar facet joints in a symptomatic population: prevalence on magnetic resonance imaging","volume":"29","author":"Doyle","year":"2004","unstructured":"Doyle AJMerrilees M.Synovial cysts of the lumbar facet joints in a symptomatic population: prevalence on magnetic resonance imaging. Spine (Phila Pa 1976). 2004;29(8):874-878."},{"issue":"12","key":"bib2","series-title":"J Am Acad Orthop Surg","first-page":"829","article-title":"Evaluation and treatment of lumbar facet cysts","volume":"24","author":"Boody","year":"2016","unstructured":"Boody BSSavage JW.Evaluation and treatment of lumbar facet cysts. J Am Acad Orthop Surg. 2016;24(12):829-842."},{"issue":"4","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"321","article-title":"Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment","volume":"17","author":"Epstein","year":"2004","unstructured":"Epstein NE.Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment. J Spinal Disord Tech. 2004;17(4):321-325."},{"issue":"8","key":"bib4","series-title":"Eur Spine J","first-page":"1176","article-title":"Spinal lumbar synovial cysts. Diagnosis and management challenge","volume":"15","author":"Khan","year":"2006","unstructured":"Khan AMGirardi F.Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J. 2006;15(8):1176-1182."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"53","article-title":"Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience","volume":"93","author":"Lyons","year":"2000","unstructured":"Lyons MKAtkinson JLWharen REDeen HGZimmerman RSLemens SM.Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience. J Neurosurg. 2000;93(1)(suppl):53-57."},{"issue":"2","key":"bib6","series-title":"J Spinal Disord Tech","first-page":"127","article-title":"Lumbar synovial cysts of the spine: an evaluation of surgical outcome","volume":"18","author":"Khan","year":"2005","unstructured":"Khan AMSynnot KCammisa FPGirardi FP.Lumbar synovial cysts of the spine: an evaluation of surgical outcome. J Spinal Disord Tech. 2005;18(2):127-131."},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","first-page":"14","article-title":"Diagnostic challenge: bilateral infected lumbar facet cysts\u2014a rare cause of acute lumbar spinal stenosis and back pain","volume":"5","author":"Freedman","year":"2010","unstructured":"Freedman BABui TLYoon ST.Diagnostic challenge: bilateral infected lumbar facet cysts\u2014a rare cause of acute lumbar spinal stenosis and back pain. J Orthop Surg Res. 2010;5(1):14."},{"issue":"3","key":"bib8","series-title":"J Infect Dis","first-page":"286","article-title":"Nocardial infections in the United States, 1972-1974","volume":"134","author":"Beaman","year":"1976","unstructured":"Beaman BLBurnside JEdwards BCausey W.Nocardial infections in the United States, 1972-1974. J Infect Dis. 1976;134(3):286-289."},{"issue":"4","key":"bib9","series-title":"Mayo Clin Proc","first-page":"403","article-title":"Nocardiosis: updates and clinical overview","volume":"87","author":"Wilson","year":"2012","unstructured":"Wilson JW.Nocardiosis: updates and clinical overview. Mayo Clin Proc. 2012;87(4):403-407."},{"issue":"5","key":"bib10","series-title":"Leuk Lymphoma","first-page":"764","article-title":"Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: systematic review and meta-analysis","volume":"50","author":"Raanani","year":"2009","unstructured":"Raanani PGafter-Gvili APaul MBen-Bassat ILeibovici LShpilberg O.Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: systematic review and meta-analysis. Leuk Lymphoma. 2009;50(5):764-772."},{"issue":"1","key":"bib11","series-title":"Interv Pain Med","first-page":"100395","article-title":"Nocardial epidural abscess: a case report","volume":"3","author":"Galibov","year":"2024","unstructured":"Galibov MChung MJamal FNocardial epidural abscess: a case report. Interv Pain Med. 2024;3(1):100395."},{"issue":"49","key":"bib12","series-title":"Medicine (Baltim)","first-page":"e13541","article-title":"Nocardial spinal epidural abscess with lumbar disc herniation: a case report and review of literature","volume":"97","author":"Ma","year":"2018","unstructured":"Ma FKang MLiao YHNocardial spinal epidural abscess with lumbar disc herniation: a case report and review of literature. Medicine (Baltim). 2018;97(49):e13541."},{"key":"bib13","series-title":"IDCases","first-page":"e01524","article-title":"Case of multi-drug resistant Nocardia nova as the causative agent of cervical spine osteomyelitis in an immunocompetent adult","volume":"29","author":"Check","year":"2022","unstructured":"Check LRagunathan AScibelli NMangano A.Case of multi-drug resistant Nocardia nova as the causative agent of cervical spine osteomyelitis in an immunocompetent adult. IDCases. 2022;29:e01524."},{"issue":"8","key":"bib1","series-title":"Spine (Phila Pa 1976)","first-page":"874","article-title":"Synovial cysts of the lumbar facet joints in a symptomatic population: prevalence on magnetic resonance imaging","volume":"29","author":"Doyle","year":"2004","unstructured":"Doyle AJMerrilees M.Synovial cysts of the lumbar facet joints in a symptomatic population: prevalence on magnetic resonance imaging. Spine (Phila Pa 1976). 2004;29(8):874-878."},{"issue":"12","key":"bib2","series-title":"J Am Acad Orthop Surg","first-page":"829","article-title":"Evaluation and treatment of lumbar facet cysts","volume":"24","author":"Boody","year":"2016","unstructured":"Boody BSSavage JW.Evaluation and treatment of lumbar facet cysts. J Am Acad Orthop Surg. 2016;24(12):829-842."},{"issue":"4","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"321","article-title":"Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment","volume":"17","author":"Epstein","year":"2004","unstructured":"Epstein NE.Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment. J Spinal Disord Tech. 2004;17(4):321-325."},{"issue":"8","key":"bib4","series-title":"Eur Spine J","first-page":"1176","article-title":"Spinal lumbar synovial cysts. Diagnosis and management challenge","volume":"15","author":"Khan","year":"2006","unstructured":"Khan AMGirardi F.Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J. 2006;15(8):1176-1182."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"53","article-title":"Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience","volume":"93","author":"Lyons","year":"2000","unstructured":"Lyons MKAtkinson JLWharen REDeen HGZimmerman RSLemens SM.Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience. J Neurosurg. 2000;93(1)(suppl):53-57."},{"issue":"2","key":"bib6","series-title":"J Spinal Disord Tech","first-page":"127","article-title":"Lumbar synovial cysts of the spine: an evaluation of surgical outcome","volume":"18","author":"Khan","year":"2005","unstructured":"Khan AMSynnot KCammisa FPGirardi FP.Lumbar synovial cysts of the spine: an evaluation of surgical outcome. J Spinal Disord Tech. 2005;18(2):127-131."},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","first-page":"14","article-title":"Diagnostic challenge: bilateral infected lumbar facet cysts\u2014a rare cause of acute lumbar spinal stenosis and back pain","volume":"5","author":"Freedman","year":"2010","unstructured":"Freedman BABui TLYoon ST.Diagnostic challenge: bilateral infected lumbar facet cysts\u2014a rare cause of acute lumbar spinal stenosis and back pain. J Orthop Surg Res. 2010;5(1):14."},{"issue":"3","key":"bib8","series-title":"J Infect Dis","first-page":"286","article-title":"Nocardial infections in the United States, 1972-1974","volume":"134","author":"Beaman","year":"1976","unstructured":"Beaman BLBurnside JEdwards BCausey W.Nocardial infections in the United States, 1972-1974. J Infect Dis. 1976;134(3):286-289."},{"issue":"4","key":"bib9","series-title":"Mayo Clin Proc","first-page":"403","article-title":"Nocardiosis: updates and clinical overview","volume":"87","author":"Wilson","year":"2012","unstructured":"Wilson JW.Nocardiosis: updates and clinical overview. Mayo Clin Proc. 2012;87(4):403-407."},{"issue":"5","key":"bib10","series-title":"Leuk Lymphoma","first-page":"764","article-title":"Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: systematic review and meta-analysis","volume":"50","author":"Raanani","year":"2009","unstructured":"Raanani PGafter-Gvili APaul MBen-Bassat ILeibovici LShpilberg O.Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: systematic review and meta-analysis. Leuk Lymphoma. 2009;50(5):764-772."},{"issue":"1","key":"bib11","series-title":"Interv Pain Med","first-page":"100395","article-title":"Nocardial epidural abscess: a case report","volume":"3","author":"Galibov","year":"2024","unstructured":"Galibov MChung MJamal FNocardial epidural abscess: a case report. Interv Pain Med. 2024;3(1):100395."},{"issue":"49","key":"bib12","series-title":"Medicine (Baltim)","first-page":"e13541","article-title":"Nocardial spinal epidural abscess with lumbar disc herniation: a case report and review of literature","volume":"97","author":"Ma","year":"2018","unstructured":"Ma FKang MLiao YHNocardial spinal epidural abscess with lumbar disc herniation: a case report and review of literature. Medicine (Baltim). 2018;97(49):e13541."},{"key":"bib13","series-title":"IDCases","first-page":"e01524","article-title":"Case of multi-drug resistant Nocardia nova as the causative agent of cervical spine osteomyelitis in an immunocompetent adult","volume":"29","author":"Check","year":"2022","unstructured":"Check LRagunathan AScibelli NMangano A.Case of multi-drug resistant Nocardia nova as the causative agent of cervical spine osteomyelitis in an immunocompetent adult. IDCases. 2022;29:e01524."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25220.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25220.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25220.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:23Z","timestamp":1769684963000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25220.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":26,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.3171\/case25220","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}