PRIMARY NOCARDIAL MENINGITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

Nocardia is an important but often overlooked opportunisticinfection agent in immunocompromised hosts. Nocardiosis is primarilypulmonary; central nervous system involvement, usually in theform of brain abscess, is less common. Primary nocardial meningitiswithout associated brain abscess and pulmonary lesion is extremelyrare and poses a formidable diagnostic challenge. We reporton a patient with systemic lupus erythematosus who presentedwith a clinical picture of chronic meningitis which failed torespond to empirical antibiotic treatment. She deterioriatedand succumbed. Post-mortem examination showed nocardial meningitiswithout associated brain abscesses. Nocardial meningitis shouldbe considered a differential diagnosis of subacute meningitisin immunocompromised hosts. KEY WORDS: Nocardia, Nocardiosis, Immunocompromised hosts