• Acute Renal Necrosis DDx (emphasis on infectious agents)
  • Viral: HSV, VZV, CMV
  • Toxoplasma
  • Syphilis
  • Aspergillus 
  • Behçet’s disease
  • Intraocular lymphoma
  
  

  Posted 03/22/17 09:57:10 AM by Matthew Cummings

• Multiple-ring enhancing CNS Lesions = MAGIC DR
  • Metastases
  • Abscess --> bacterial (Mycobacteria, Nocardia, Actinomyces, Listeria); fungal (endemic mycoses, Aspergillus); parasitic (neurocystircercosis, Echinococcus, and Entamoeba);
  • Glioma/CNS neoplasms (e.g. lymphoma)
  • Infarct
  • Contusion
  • Demyelination (e.g. MS, ADME)
  • Resolving hematoma/radionecrosis
  
  

  Posted 03/22/17 10:01:52 AM by Matthew Cummings

• Nocardiosis
  •  Nocardia: Gram-positive branching, filamentous rod. 
    • DDx includes Actinomyces --> Nocardia is weakly acid fast, Actinomyces is not
  • Sites of infection (1994 review of 1050 cases):
    • Pulmonary (most common): diverse symptoms (acute/subacute), imaging w/ nodules/mass/interstitial infiltrates/consolidation/pleural effusion
    • CNS: abscess (ring-enhancing--single or multiple), meningitis
    • Cutaneous:  ulcerations, pyoderma, cellulitis, nodules, and subcutaneous abscesses 
    • Other extra-pulmonary sites: eyes (endopthalmitis, retinitis), bone (osteomyelitis)
  • TMP-SMX is mainstay of therapy often in combination w/ carbapenem/linezolid
  
  

  Posted 03/22/17 10:15:51 AM by Matthew Cummings

• For further reading...

  Nocardiosis: Updates and Clinical Overview (Mayo Clinical Review)
  Multiple ring-enhancing lesions of the brain (J Postgrad Med)
  Acute Retinal Necrosis: Features, Management, and Outcomes (Opthalmology 2007)
  
  

  Posted 03/22/17 10:18:33 AM by Matthew Cummings

---

Created by Christopher Kelly

Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.