A 54-year-old homosexual man was diagnosed as human immunodeficiency virus-1-positive in 1992. He was admitted to a tertiary hospital in March, 2000 because of right flank pain, fever and intermittent cough. A chest roentgenogram showed right-sided pleural effusion, and closed thoracostomy was performed for drainage Salmonella species and Escherichia coli were isolated from the pleural fluid. In spite of 6 weeks of antibiotic treatment, fever did not subside and the general condition gradually deteriorated, and under the diagnosis of lung abscess with empyema thoracis, right pleuropneumonectomy was performed. The general condition improved postoperatively until day 10 when he showed sudden change in mental status to stuporous and developed focal seizure. Brain CT showed multiple abscesses in right frontal and left frontotemporal lobes and he expired on postoperative day 14.