Neurocysticercosis, Nocardiosis, or Both: A Case Report of Complex Central Nervous System Infection in an Immunocompromised Patient

Abstract

Introduction: Neurocysticercosis is a known cause of central nervous system (CNS) infections in endemic areas, often presenting with symptoms such as seizures and neurological deficits. However, distinguishing it from other infections, such as nocardiosis, can be challenging, particularly in immunocompromised patients.Case Report: We present the case of a middle-aged woman with advanced human immunodeficiency virus (HIV) who presented with fever and altered mental status. She was initially diagnosed with neurocysticercosis based on radiological findings; however, her condition worsened despite treatment. Further investigations revealed disseminated nocardiosis. Nocardia could have either coexisted with or been mistaken for neurocysticercosis.Conclusion: This case emphasizes the importance of considering nocardiosis early in the differential diagnosis of CNS infections in HIV patients. Timely identification and treatment of Nocardia is crucial to prevent complications and improve outcomes. This case also underscores the importance of a comprehensive diagnostic approach and the value of maintaining a broad differential diagnosis in complex cases involving immunocompromised patients.