Pleurocerebral Nocardia in a patient with human immunodeficiency virus

OBJECTIVE: To report a case of Nocardia asteroides pneumonia and subsequent brain abscess in an immunocompromised host. SETTING: Private, community, teaching hospital. PATIENT: A man readmitted to the hospital for a third time with a fatal brain abscess, after responding to (misdirected) therapy in previous admissions. INTERVENTIONS: Treatment with cefuroxime, erythromycin, trimethoprim/sulfamethoxazole at different times. RESULTS: Patient's condition deteriorated and he died after one month of intravenous trimethoprim/sulfamethoxazole therapy. CONCLUSIONS: Because it is an infection of the immunocompromised host, it may be considered an AIDS-defining illness. Several other similar cases have been reported in the literature.