A Successful Management of Concurrent Infection with Cranial <i>Nocardia gipuzkoensis</i> and Pulmonary <i>Klebsiella pneumoniae</i>: A Case Report

Abstract

Introduction: Successful management of concurrent infection with cranial Nocardia gipuzkoensis and pulmonary Klebsiella pneumoniae has never been previously described. Case Presentation: A 71-year-old female was referred to our hospital due to an intracranial space-occupying lesion persisting for over 20 days. Her initial chief complaints suggested cranial and pulmonary inflammation. Subsequently, drainage of the brain lesion was performed, and N. gipuzkoensis infection was confirmed through microbial culture and metagenomic next-generation sequencing (mNGS). Sputum culture identified K. pneumoniae infection. Based on antimicrobial susceptibility test results and allergic history, the patient showed improvement after two weeks of intravenous meropenem (2 g/8 h) combined with vancomycin (1 g/12 h). Neurological recovery was achieved, followed by over six weeks of oral Linezolid (0.6 g/12 h) and Levofloxacin (0.5 g/24 h). Conclusions: This case reports the successful management of concurrent infections, providing supporting evidence for the potential to shorten intravenous administration in nocardiosis treatment.