NOCARDIAL BRAIN-ABSCESS IN A RENAL-TRANSPLANT RECIPIENT SUCCESSFULLY TREATED WITH TRIPLE ANTIMICROBIALS

Nocardia is a serious opportunistic infection in renal transplant reci pients and nocardial brain abscess in these patients has a high mortal ity. In addition to antimicrobial therapy, treatment usually involves craniotomy and excision of the abscess. We describe a renal transplant recipient maintained on cyclosporine and prednisone developing Nocard ia Asteroides brain abscess. After stereotactic aspiration of the absc ess, successful treatment was achieved by triple therapy with trimetho prim sulfamethoxazole (TMP/SMX), ceftriaxone and amikacin. The allogra ft function remained stable. Long-term prophylaxis with TMP/SMX is nec essary to prevent the relapse of nocardia.