What question did this study set out to answer?

To describe a case of multiple brain abscesses caused by Nocardia brevicatena in a patient with a tuberculosis history.

April 17, 2026Open Access

Multiple Intracranial Nocardia brevicatena Abscesses in a Patient with a Previous History of Tuberculosis: A Case Report

Key Points

To describe a case of multiple brain abscesses caused by Nocardia brevicatena in a patient with a tuberculosis history.
Detailed symptoms and diagnosis of a 55-year-old man with TB history.
MRI imaging was utilized to identify brain nodules and edema.
Next-generation sequencing was employed for pathogen identification
Treatment involved specific anti-Nocardia medications over 45 days.
Initial anti-TB treatment was ineffective against N. brevicatena infection.
Next-generation sequencing accurately identified the pathogen, leading to effective treatment.
Symptom improvement followed the initiation of anti-Nocardia drugs.
The patient fully recovered with normal MRI results after treatment.

Abstract

Background: Nocardia brevicatena ( N. brevicatena ) is an uncommon cause of brain infections, frequently mistaken for intracranial tuberculosis, especially in patients with a tuberculosis (TB) history, leading to improper treatment. This case report outlines the symptoms, diagnosis, and treatment of a patient with multiple brain abscesses from N. brevicatena after laryngeal TB, highlighting the importance of next-generation sequencing (NGS) for accurate diagnosis. Case Presentation: This report details a 55-year-old man with a history of TB. Symptoms included dizziness, headache, and unsteady gait, with MRI revealing brain nodules and edema. He initially received anti-TB treatment, but it was ineffective. NGS identified N. brevicatena , and TB tests were negative. He was treated with anti-Nocardia drugs (compound sulfamethoxazole tablets (0.96 g, orally twice daily), amikacin sulfate injection (0.6 g, once daily), and imipenem-cilastatin sodium (0.5 g, every 6 hours)), leading to symptom improvement and MRI changes. Symptoms worsened when treatment was paused but resolved within a week of resuming therapy, following 45 days of treatment, the patient fulfilled the discharge criteria. After seven months, the patient fully recovered with normal MRI results. Conclusion: Intracranial N. brevicatena infections are frequently misdiagnosed as TB in patients with a TB history. NGS of blood or cerebrospinal fluid accurately detects pathogens, and TB Xpert helps rule out TB. Both are crucial for targeted treatment and better patient outcomes. Keywords: case report, Nocardia, intracranial infection

Bookmark

View Full Paper

Cite This Study

Li et al. (Wed,) studied this question.

synapsesocial.com/papers/69e1cdc45cdc762e9d85702b https://doi.org/https://doi.org/10.2147/idr.s603379

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Bookmark

View Full Paper