A Rare Case of Cerebellar Abscess Caused by

Background: Gram-positive opportunistic bacteria of the species are responsible for a large spectrum of infections, such as pneumonia, skin infections, and more widespread conditions, including brain abscesses.

Case Description: A 67-year-old male patient suffered from headache, gait disorder, and vertigo for a week before admission to our department. An enhanced magnetic resonance imaging scan revealed a mediosagittal hyperintense infratentorial lesion with concomitant compression of the fourth ventricle. The patient underwent surgical treatment with general anesthesia. The frozen section did not reveal any tumoral tissue but rather a purulent content. He was comatose on the 1 postoperative day, and he underwent a follow-up computed tomography (CT) scan, which revealed triventricular hydrocephalus. The external ventricular drain was performed, and a follow-up CT scan revealed significant improvement of hydrocephalus. Matrix-Assisted Laser Desorption Ionization Time of Flight did not reveal any causative agent from the intraoperative content, but the 16s ribosomal DNA method confirmed . The patient was intravenously treated with ceftriaxone and trimethoprim/sulfamethoxazole and died on the 5 postoperative day.

Conclusion: Nocardiosis presents a rare Gram-positive bacterial infection that typically affects immunocompromised hosts. -caused brain abscesses present a significant challenge in its treatment for its atypical presentation and slow culture growth.