Nocardial brain abscess in a patient with AIDS

Abstract

A 34-year-old man with AIDS presented with progressive slurred speech and general weakness for 2 months. His CD4 count was 29 cells/µL and viral load 407 copies/mL. Physical examination revealed clear consciousness, and meningeal signs were negative. Brain magnetic resonance imaging with contrast (Figure 1) revealed multiple thick ring enhanced lesions over bilateral cerebral, cerebellar hemispheres and brain stem. The tissue was obtained via craniotomy. Gram staining revealed scattered, weak gram-positive, curved rods (Figure 2).