Idiopathic CD4 lymphocytopenia (ICL), also known as non-HIV AIDS, is a rare disease characterized by opportunistic infections, malignancies, and autoimmune diseases. Idiopathic CD4 lymphocytopenia is defined as CD4+ T-lymphocyte level below 300/mm(3) in at least two measurements or less than 20% of total lymphocytes, which cannot be explained by any other condition, including HIV infection. Nocardia spp. are opportunistic microorganisms that is a frequent cause of infection in immunocompromised individuals. In this paper, we report a 50-year-old patient with ICL and intracranial brain abscess due to Nocardia farcinica and review th literature for related articles published between April 2012 and December 2018. These data suggest that there may be an underlying immunosuppression in adult patients who have infections that are recurrent, refractory, and caused by opportunistic pathogens.