Nocardial brain abscess in an immunocompetent patient and review of literature

Background Nocardial brain abscesses are associated with significant morbidity and mortality rates. The optimal management remains unclear. Case presentation We report a case of 49-year-old woman presented with dizziness, progressive headache for 3 days, accompanied with left arm twitched for twice. The patient underwent a right parietal craniotomy for resection of the lesion. Gross total resection of the lesion was achieved. There were no new neurological deficits post-operatively, and no lesions was demonstrated on Gd-enhanced MRI images at six months follow-up. Conclusions After review of the literature and experience learned from our case, we suggest that craniotomy and surgical resection of the lesions, instead of aspiration, is a safe, efficacious treatment for the patient with nocardial brain abscesses. Long-term chemotherapy and follow-up is mandatory in all cases.