Disseminated Nocardia farcinica with multiple cerebral abscesses in a patient receiving induction immunosuppression for autoimmune hepatitis: case report - Takeaways - MDSpire

Disseminated Nocardia farcinica with multiple cerebral abscesses in a patient receiving induction immunosuppression for autoimmune hepatitis: case report

  • By

  • Akram Alnounou

  • Dimitar Bahariev

  • John Brown

  • Henry Zou

  • Harry Boamah

  • July 16, 2026

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  • 1

    Nocardiosis is an opportunistic infection primarily affecting immunocompromised patients, particularly those on corticosteroids or immunosuppressive therapies.

  • 2

    A 55-year-old man with autoimmune hepatitis developed disseminated Nocardia farcinica with multiple cerebral abscesses after interruption of TMP-SMX prophylaxis.

  • 3

    Neuroimaging revealed multiple ring-enhancing intracerebral lesions, and microbiological confirmation of Nocardia farcinica was obtained from abscess drainage.

  • 4

    The patient received susceptibility-guided combination therapy with imipenem-cilastatin and TMP-SMX, leading to gradual neurological improvement.

  • 5

    Disseminated nocardiosis should be considered in immunosuppressed patients with neurological decline and ring-enhancing lesions, especially during outpatient therapy transitions.

Original Source(s)

Disseminated Nocardia farcinica with multiple cerebral abscesses in a patient receiving induction immunosuppression for autoimmune hepatitis: case report

  • by Akram Alnounou, Dimitar Bahariev, John Brown, Henry Zou, Harry Boamah

  • July 16, 2026

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