A 33-year-old white man with previously undiagnosed and relatively asymptomatic pulmonary alveolar proteinosis had a Jacksonian seizure. The diagnosis of pulmonary alveolar proteinosis was established by open lung biopsy. A craniotomy was performed, and a Nocardia brain abscess was excised. The patient was treated with sulfonamides and recovered. The intra-alveolar phospholipid that accumulates in this disease tends to become infected by opportunistic fungi, particularly Nocardia species. As many as 30% of cases of nocardiosis may show cerebral involvement.
Supena R, Karlin D, Strate R, Cramer PG. Pulmonary Alveolar Proteinosis and Nocardia Brain Abscess: Report of a Case. Arch Neurol. 1974;30(3):266–268. doi:10.1001/archneur.1974.00490330074014
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