[Two cases of Nocardia farcinica brain abscess]

Brain abscess caused by Nocardia is a relatively rare disease, but its prognosis is poor, with the fatality being 3 times as high as that of other types of brain abscess. Nocardiosis caused by N. farcinica has higher fatality rates than nocardiosis caused by the other bacteria of the genus Nocardia. We report two cases of brain abscess caused by N. farcinica. Case 1: 72-year-old immunocompetent man. In this case, the disease healed in response to burr hole drainage and treatment with antibiotics (pazufloxacin, ciprofloxacin). Case 2: A 78-year-old woman with a history of liver cirrhosis. This patient received burr hole drainage and treatment with multiple antibiotics (sulfamethoxazole/trimethoprim, pazufloxacin, meropenem, amikacin, minocycline, and linezolid). Her brain abscess tended to alleviate but her general condition worsened, leading to death. N. farcinica is often resistant to multiple antibiotics. For treatment of brain abscess caused by this bacterium, it is essential to perform pathogen identification and a drug sensitivity test immediately, and to select optimum antibiotics, taking into account the general condition of individual patients.