Matthew A Moffa, Thomas L Walsh, Whitney Rich, Andrea Snitchler, Nathan R Shively
A 51-year-old man with alcoholic liver cirrhosis presented with a lung mass and innumerable ring-enhancing brain lesions, initially diagnosed and treated as metastatic malignancy. Autopsy ultimately revealed disseminated nocardiosis, underscoring the importance of early tissue biopsy with modified acid-fast staining and microbiologic cultures when evaluating multisystem lesions in immunocompromised patients.