Nocardia exalbida brain abscess in a patient with follicular lymphoma

Nocardial brain abscess is a rare but severe complication in patients with malignancy. Nocardia exalbida was isolated in Japan and characterized within the genus Nocardia. We present the first report of N. exalbida brain abscess in a 63-year-old male patient with follicular lymphoma. He developed abnormal neurological findings during follicular lymphoma treatment, brain CT revealed ring-enhancing, multiloculated lesions, and N. exalbida was detected by aspiration of the lesion. He was successfully treated with trimethoprime-sulfamethoxazole (TMP-SMX) and meropenem without craniotomy or repeat aspirations. It should be noted that such an infection can occur in patients treated with conventional chemotherapy against malignant lymphoma.