Clinical Report: Disseminated Nocardia farcinica with Multiple Cerebral Abscesses

Background

Nocardiosis is an opportunistic infection primarily affecting immunocompromised individuals, particularly those on immunosuppressive therapies. The central nervous system is frequently involved, leading to significant morbidity and mortality.

Data Highlights

No numerical or trial data provided in the article.

Key Findings

• A 55-year-old man with autoimmune hepatitis developed multiple cerebral abscesses due to Nocardia farcinica.
• He had received high-dose corticosteroids and azathioprine, with TMP-SMX prophylaxis interrupted prior to presentation.
• Neuroimaging revealed multiple ring-enhancing lesions, leading to the diagnosis of disseminated nocardiosis.
• Antimicrobial therapy was adjusted based on susceptibility testing.
• The case highlights the importance of considering nocardiosis in immunosuppressed patients with neurological decline.

Clinical Implications

Clinicians should maintain a high index of suspicion for nocardiosis in immunosuppressed patients presenting with neurological symptoms.

Conclusion

Disseminated nocardiosis should be considered for immunosuppressed patients with neurological decline and ring-enhancing brain lesions.

Related Resources & Content

1. CDC, Clinical Overview of Nocardiosis, 2025 -- Clinical Overview of Nocardiosis
2. Frontiers in Medicine, Case Report: Basal ganglia brain abscess caused by Nocardia farcinica -- Case Report: Basal ganglia brain abscess caused by Nocardia farcinica
3. Open Forum Infectious Diseases, Factors Influencing Disseminated Nocardiosis and Associated Outcomes in Different Host Risk Categories -- Factors Influencing Disseminated Nocardiosis and Associated Outcomes in Different Host Risk Categories
4. Frontiers in Immunology — Disseminated Mycobacterium kansasii infection with osseous involvement in anti-interferon-γ autoantibody-associated adult-onset immunodeficiency: a case report and literature review
5. Frontiers in Medicine — Case Report: pharmaceutical care in a case of complicated urinary tract infection combined with disseminated Nocardia brasiliensis infection
6. Clinical Overview of Nocardiosis | Nocardiosis | CDC
7. European society of Clinical Microbiology and Infectious Diseases guidelines on diagnosis and treatment of brain abscess in children and adults