A case of brain abscesses infected by Nocardia asteroids in a child with steroid-resistant nephrotic syndrome was reported. An 8-year-old male patient was clinically diagnosed as primary nephrotic syndrome (steroid-resistant). Renal biopsy pathology showed focal segmental glomerulosclerosis (typical). On the fourth day after Reno puncture, he suffered from persistent high fever, convulsions, and headache. He received anti-infection and anticoagulant treatment, but his health did not improve. Repeat cerebral MRI showed multiple brain abscesses, puncture liquid culture of the brain abscesses confirmed Nocardia asteroids infection. After multiple antibiotics combined glucocorticoid therapy for 2 months, patient conditions improved, including body temperature returned to normal, headache relief, and brain abscess narrowing down. The case indicated that once refractory pyogenic diseases occurred after routine antibiotics therapy in children with nephrotic syndrome receiving corticosteroids and immunosuppressive treatment, nocardiosis and other opportunistic pathogen infections and attentions on the dosage of corticosteroid and immunosuppressants should be considerate at the same time.