Abstract Details

Title Nocardia Brain Abscess and Zanubrutinib Treatment for Marginal Zone Lymphoma: A Case Report

Topic Infectious Disease

Presentation(s) P2 - Poster Session 2 (2:45 PM-3:45 PM)

Poster/Presentation
Number 072

Objective This study aims to present a rare case of Nocardia paucivorans intracranial abscess in a patient undergoing zanubrutinib therapy for recurrent marginal zone lymphoma (MZL) and to elucidate the clinical challenges and management strategies associated with this complex clinical scenario.

Background Nocardia species are infrequent causes of central nervous system (CNS) infections, predominantly affecting immunocompromised individuals. Diagnosis of CNS nocardiosis is often delayed due to its diverse presentations and slow bacterial growth. Furthermore, the intersection of hematological malignancies and opportunistic infections poses additional complexities, especially in patients undergoing novel targeted therapies like zanubrutinib.

Design/Methods We present a detailed case report of a 72-year-old female with relapsing MZL who developed neurological symptoms while receiving zanubrutinib therapy. Clinical presentation, diagnostic workup, neurosurgical intervention, microbiological identification, antimicrobial therapy, and patient outcomes are described. Relevant literature regarding CNS nocardiosis, hematological malignancies, and Bruton’s tyrosine kinase inhibitor therapy is reviewed to provide context for understanding the clinical implications of this case.

Results The patient presented with headaches, weakness, and difficulty walking, with imaging revealing an intraparenchymal brain abscess. Intraoperative cultures identified Nocardia paucivorans, leading to tailored antibiotic therapy and subsequent clinical improvement. Timely recognition and treatment resulted in a positive outcome. The case highlights the diagnostic and therapeutic challenges associated with CNS nocardiosis, particularly in the context of immunocompromised patients receiving targeted therapies.

Conclusions This case underscores the importance of considering opportunistic infections in immunocompromised patients, especially those undergoing novel targeted therapies like zanubrutinib. It emphasizes the need for prompt recognition, aggressive management, and multidisciplinary collaboration in treating CNS nocardiosis. Furthermore, it highlights the potential risks associated with BTK inhibitor therapy and the necessity for heightened vigilance among clinicians managing patients with hematological malignancies.

Authors/Disclosures
Jimmy Meade PRESENTER	Mr. Meade has nothing to disclose.
Warren Back	No disclosure on file
Salman Arif	No disclosure on file
Komal Masood	No disclosure on file
Claudiu Georgescu	No disclosure on file

��ɫ��

��ɫ��