ArticleCurrent HIV research2026
Brain Abscess Caused by
Article in Current HIV research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundNocardia brain abscess is a rare opportunistic infection in people living with HIV at an advanced stage. Immunosuppression, especially with very low CD4 counts and non-adherence to treatment, increases the risk. These infections are diagnostically challenging due to their nonspecific presentation and the limited sensitivity of routine molecular panels in detecting Nocardia. CASE PRESENTATION: We present a 57-year-old HIV-positive female who developed a brain abscess after discontinuing antiretroviral therapy (ART) in 2019. She presented in 2023 with progressive headaches, fever, and vomiting. MRI revealed a ring-enhancing lesion, suggesting a brain tumor or severe infection. Craniotomy with pus aspiration confirmed Nocardia sp. The patient was treated with trimethoprim/sulfamethoxazole (TMP-SMX) and imipenem-cilastatin, showing significant improvement after two weeks of intravenous therapy. The patient was then discharged on oral TMP-SMX.
conclusionThis case highlights the diagnostic challenges of nocardial brain abscesses in patients with HIV and highlights the importance of diagnosis, early neurosurgical intervention, and targeted antimicrobial therapy in improving outcomes.
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