Multiple Intracranial Nocardia brevicatena Abscesses in a Patient with a Previous History of Tuberculosis: A Case Report

Background: after laryngeal TB, highlighting the importance of next-generation sequencing (NGS) for accurate diagnosis. Case Presentation: , and TB tests were negative. He was treated with anti-Nocardia drugs (compound sulfamethoxazole tablets (0.96 g, orally twice daily), amikacin sulfate injection (0.6 g, once daily), and imipenem-cilastatin sodium (0.5 g, every 6 hours)), leading to symptom improvement and MRI changes. Symptoms worsened when treatment was paused but resolved within a week of resuming therapy, following 45 days of treatment, the patient fulfilled the discharge criteria. After seven months, the patient fully recovered with normal MRI results. Conclusion: infections are frequently misdiagnosed as TB in patients with a TB history. NGS of blood or cerebrospinal fluid accurately detects pathogens, and TB Xpert helps rule out TB. Both are crucial for targeted treatment and better patient outcomes.