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.