Apparent cure of intracranial Nocardia asteroides infection by minocycline.

Currently preferred therapy for CNS Nocardia infection is high-dose sulfonamide coupled with surgical drainage. Neither of these could be used in our patient; this led to therapy with minocycline alone. Several months after completion of minocycline therapy, the patient apparently is cured. His favorable outcome probably resulted from a combination of susceptibility of the organism to minocycline coupled with good CNS penetration of the agent resulting in CNS levels of drug 16 to 22 times higher than the Nocardia inhibitory concentration.