Photo Quiz: An Unexpected Organism Isolated from an Intracranial Epidural Abscess

Abstract

A 70-year-old Spanish man was referred to our emergency room (ER) for acute generalized epileptic seizures, which had developed over the previous 24 h. Two years before, the patient had been diagnosed with multiple nocardial brain abscesses that had been successfully treated without recurrence and complications during followup. The patient's medical history also included type 2 diabetes mellitus, high blood pressure, persistent lymphopenia (CD4 T lymphocyte count of 120 cells/l), and hypogammaglobulinemia, with a bone marrow biopsy with no significant findings.