- Brain abscess can easily be confused with metastatic tumors mainly due to the similarities in the magnetic resonance imaging (MRI) appearances. Nocardial brain abscesses are extremely rare and account for about 2% of all brain abscesses. Nocardial infections can spread contiguously or hematogenously. Misdiagnosis may influence treatment as well as survival. Herewith, we discuss the radiologic findings, mechanisms of spread and treatment strategies of a patient harboring multiple nocardial abscesses who was misdiagnosed as metastatic brain tumor and administered radiation therapy. We concluded that in cases with unilateral multiple ring-enhanced lesions on MRI without biopsy and histopathological evaluation, brain abscesses should be taken into consideration.
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