Nocardia abscessus brain abscess in an immunocompetent patient with bronchiectasis

Abstract

A 56 year-old woman presented with new onset focal seizure with a history of bronchiectasis. Brain abscess was diagnosed by magnetic resonance. She was confirmed to be immunocompetent and had histoplasmosis, tuberculosis, and infective endocarditis ruled out. Nocardia sp. was isolated from the brain abscess and identified as Nocardia abscessus complex by 16S rRNA sequencing. She was discharged on trimethoprim/sulfamethoxazole. Nocardia sp. is a cause of brain abscesses in patients with underlying pulmonary structural disease like bronchiectasis. Nocardia identification is of paramount importance as it is not treated with empiric antimicrobial therapy.