Primary cerebral abscesses due to Nocardia farcinica in an AIDS patient

Abstract

Nocardia species are aerobic, Gram positive, partially acid-fast bacilli, acquired through the respiratory tract or the skin. Nocardial organisms disseminate from the primary site of infection from haematogenous source to the brain, especially in immunocompromised patients; less frequently, central nervous system involvement may be primary, in both immunocompetent and immunodeficient subjects. Cerebral nocardiosis is infrequent and present in only 2% of all the brain abscesses. Early diagnosis followed by surgical resection and prolonged antibiotic therapy may improve the poor prognosis and the morbimortality of these patients. Nocardia spp. cause actinomicetomas more frequently than cerebral nocardosis in inmunocompetent hosts. Here we describe an HIV seropositive patient who developed primary cerebral abscesses due to Nocardia farcinica and we include a review of the medical literature.