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.