Nonsurgical treatment of cerebral nocardiosis

In previously healthy, 49-year-old man, CNS infection due to Nocardia asteroides was manifested initially as sterile meningitis and then as a single large brain abscess and was treated successfully with medical therapy alone. Resolution of the brain abscess was documented with serial computed tomographic scans. The strain of N asteroides was sensitive to both sulfisoxazole and ampicillin. Although surgical intervention must always be considered in the treatment of brain abscess caused by N asteroides, medical therapy is preferable if the patient responds initially.