eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2017-09-28 5 9 248 251 10.12691/ajmcr-5-9-6 AJMCR2017596 article Balakrishnan Valliyot 1 Sarosh Kumar K 1 Harikrishnan Mohan harikrishnan.mohan@yahoo.com 1 Sarin S 1 Kadeeja Beevi 1 Sudha Balakrishnan 1 Department of General Medicine, ACME-Pariyaram Disseminated nocardiosis is a serious opportunistic infection with very high mortality, especially in individuals with defective cell mediated immunity. The use of immunosuppressant therapy is associated with increased risk of opportunistic infections and in south-east Asian countries where tuberculosis is widely prevalent, Nocardia is an often overlooked and under diagnosed pathogen, with clinically very similar presentations. Here we report a case of disseminated nocardiosis presenting as multifocal brain, in a patient with Lepromatous Leprosy, who was on immunosuppressive therapy for Type 2 Lepra reactions. An early diagnosis requires high index of suspicion and interventions like stereotactic brain surgery and is a determinant for positive clinical outcome. http://pubs.sciepub.com/ajmcr/5/9/6/ajmcr-5-9-6.pdf brain abscess disseminated nocardiosis immunesuppresant therapy opportunistic infections leprosy nocardia