BACKGROUND Nocardiosis is an uncommon disease caused by aerobic gram-positive bacteria Nocardia spp. Although it is usually an opportunistic infection affecting immunocompromised patients, even one third of cases occur in immunocompetent persons. The aim of the study was to describe the course of chronic meningitis due to Nocardia infection. CASE PRESENTATION A 52-year-old patient, chalk miner, suffered from a chronic meningitis caused by an extremely rare pathogen. The patient's history was complicated and diagnostic process covered multiple examinations and consultations. Initially Kocuria rosea was cultured, yet after molecular examination the result was verified to Nocardia farcinica. Targeted antibiotic treatment was implemented, which resulted in gradual improvement of patients condition. A full recovery was achieved after one year antibiotic therapy. CONCLUSIONS 1.Nocardia farcinica is an uncommon but possible cause of chronic meningitis.2.In the case of a chronic meningitis of unknown origin multiple cerebrospinal fluid cultures should be performed as the identification of pathogen may be crucial for patient's recovery.3.In case of unusual culture, such as Kocuria spp. PCR should be performed.

中文翻译：

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法氏诺卡氏菌引起的慢性脑膜炎-病例报告。

背景诺卡氏病是由需氧革兰氏阳性菌诺卡氏菌引起的罕见疾病。尽管它通常是影响免疫功能低下患者的机会性感染，但甚至有三分之一的病例发生在具有免疫能力的人中。该研究的目的是描述由于诺卡氏菌感染引起的慢性脑膜炎的病程。病例介绍一名52岁的患者，白垩矿工，患有极罕见病原体引起的慢性脑膜炎。患者的病史很复杂，诊断过程包括多次检查和咨询。最初培养玫瑰果（Kocuria rosea），但经过分子检查后，结果证实为诺卡氏菌。实施了针对性的抗生素治疗，从而逐渐改善了患者的状况。一年的抗生素治疗后完全康复。结论1.诺卡氏菌性脑膜炎是一种罕见的但可能是引起慢性脑膜炎的病因2.在来源不明的慢性脑膜炎的情况下，应进行多次脑脊液培养，因为病原体的鉴定对患者的康复至关重要。不寻常的文化，例如Kocuria spp。PCR应进行。