Balakrishnan Valliyot¹, Sarosh Kumar K¹, Harikrishnan Mohan^1,, Sarin S¹, Kadeeja Beevi¹, Sudha Balakrishnan¹

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.

brain abscess, disseminated nocardiosis, immunesuppresant therapy, opportunistic infections, leprosy, nocardia