Nocardiosis is a life-threatening disease if unrecognized and maltreated. We describe a case of disseminated nocardiosis in a patient with idiopathic thrombocytopenic purpura under steroid therapy. She presented with a 2-week history of progressive symmetrical limb weakness, fatigue, and profuse sweating. Brain MRI revealed ring-enhanced lesions at the cerebellum and left parietal lobe with brain oedema. Chest CT revealed a left upper lobe nodule. Aspirate culture confirmed the diagnosis of nocardiosis. We administered antibiotics and dexamethasone to ameliorate the brain oedema. The patient improved clinically after 2 weeks. Follow-up brain MRI showed improvement. Clinicians should consider nocardiosis in immunocompromised patients with non-specific symptoms.