Nocardia Brain Abscess in a Patient With Sarcoidosis

Nocardia species are aerobic, gram-positive, filamentous bacteria. Infection occurs either through inhalation leading to pulmonary symptoms or inoculation presenting with skin findings. Hematogenous dissemination, although uncommon, is possible and can lead to central nervous system involvement. Nocardia brain abscess is a rare manifestation that comprises 2% of all brain abscess etiologies, mostly occurring in immunocompromised patients. Establishing a diagnosis is often difficult, especially due to its rare occurrence and the fact that it can mimic other etiologies on brain imaging including necrotic tumors. High mortality rates have been reported due to delays in establishing a diagnosis and a lack of precise treatment guidelines.