Brain abscess caused by Nocardia thailandica infection in systemic lupus erythematosus patient with steroid therapy

BACKGROUND: Nocardia is an aerobic Gram-negative bacillus belonging to actinomycetes and has been reported to be an infectious disease in healthy individuals. However, more than 60% have some underlying illnesses and are said to be opportunistic infections. CASE DESCRIPTION: The case was a 69-year-old man who had been on long-term steroids for systemic lupus erythematosus. He developed with nausea and gait disturbance and was suspected of having a brain abscess by imaging. Abscess drainage detects actinomycetes that appear to belong to the genus Nocardia and brain abscess by Nocardia thailandica using matrix-assisted laser desorption/ionization time-of-flight mass analysis (MALDITOFMS) I was diagnosed. He died during the course of the treatment, and his organs did not detect his N. thailandica at necropsy, so he concluded that bacterial death from long-term administration of antibiotics was the cause of death. CONCLUSION: N. thailandica is a very rare bacterium belonging to Nocardia asteroides and is said to easily form brain lesions. In immunocompromised patients, prophylaxis with antibiotics and detailed examination of lung lesions for surveillance were considered necessary. This paper is the first report of a brain abscess caused by N. thailandica, including a review of the literature.