Abstract
A 56-year-old male was admitted with one episode of generalized convulsions. The patient had been placed on steroid therapy for aplastic anemia, which had induced diabetes mellitus. His neurological and physical findings and laboratory data including the erythrocyte sedimentation rate, white blood cell count with differentials, and C-reactive protein, were all normal. Computerized tomography showed an enhanced mass with perifocal edema in the right parietal lobe. The chest X-ray showed an infiltrate in the right upper field. A metastatic brain tumor from the lung was suspected. At surgery, the tumor was encapsulated and cystic, containing a greenish-yellow fluid. Pathological and bacteriological examination showed a brain abscess by Nocardia asteroides. The postoperative course was uneventful with sulfisoxazole, 4 g daily, for 6 months. It is stressed that such infections are increasing with the recently more frequent use of immunosuppressive agents.
