Nocardia brasiliensis in brain abscess of a young immunocompetent patient: A case report.

Nocardia mainly affects immunocompromised individuals. We report a case of immunocompetent male, with neurological complaints for the past eight months. Contrast-enhanced MRI (CE-MRI) revealed space-occupying lesion with frontal lobe abscess. The patient underwent craniotomy, and pus was sent for microbiological diagnosis. Direct KOH-calcofluor white mount, and modified Ziehl-Neelsen (ZN) staining demonstrated thin, branching filamentous structures suggestive of Nocardia spp. Nocardia brasiliensis was confirmed through 16S rRNA sequencing. The patient received targeted antimicrobial therapy. Direct fluorescent microscopy is an important initial investigation in the diagnostic workup. Early diagnosis and appropriate management is key to favorable clinical outcomes in cerebral nocardiosis.