First case report of cerebral abscess from Nocardia terpenica and literature review

Nocardia is a Gram-positive weakly acid-fast bacterium that is ubiquitous in the environment. It represents a rare cause of infection in humans and typically causes pulmonary, cutaneous, or central nervous system (CNS) infections. CNS nocardiosis has very poor prognosis, especially in immunocompromised hosts. Nocardia terpenica is a species of Nocardia consisting of two strains that were reclassified from Nocardia brasiliensis in 2007. We report the second case of CNS Nocardia terpenica infection, and the first case of cerebral abscess from Nocardia terpenica. This report raises the index of suspicion for nocardiosis when evaluating contrast-enhancing CNS lesions, points out the capability of this species for CNS spread, and shares our experience regarding management and prognosis.