• 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

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Created by Christopher Kelly
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.