A Case of Brain Nocardiosis Successfully Treated with Minocycline

Accession number;06A0542394
Title;A Case of Brain Nocardiosis Successfully Treated with Minocycline
Author; SUZUKI CHIEKO (Hirosaki Univ., JPN) KIMURA TAMAKI (Hirosaki Univ., JPN) ARAI AKIRA (Hirosaki Univ., JPN) MAEDA TETSUYA (Hirosaki Univ., JPN) TOMIYAMA MASAHIKO (Hirosaki Univ., JPN) KANNARI KAZUYA (Hirosaki Univ., JPN) BABA MASAYUKI (Hirosaki Univ., JPN) ITABASHI CHIEKO (Hirosaki Univ., JPN) WADA RYUICHI (Hirosaki Univ., JPN)
Journal Title;Brain Nerve
Journal Code:Z0685A
ISSN:0006-8969
VOL.58;NO.6;PAGE.505-508(2006)
Figure&Table&Reference;FIG.2, REF.14
Pub. Country;Japan
Language;Japanese
Abstract;A 60-year-old man with surgically treated nocardia pyothorax was referred to our hospital since he became drowsy. Brain MRI revealed multiple brain abscesses. His cerebrospinal fluid (CSF) showed increase in polymorphonuclear cells and decrease in glucose. Since he was allergic to sulfamethoxazole trimethoprim, ceftriaxone and then minocycline were given. Minocycline resulted in dramatic improvement of neurological symtoms, MRI findings and CSF cell count. PCR analysis of 16S ribosomal DNA using his resected thoracic wall revealed that nocardia from his tissue was strain IFM0860. Strain IFM0860 nocardia was found to be sensitive to minocycline but not to sulfamethoxazole trimethoprim and ceftriaxone. Intravenous administration of minocycline was followed by three-year per os administration of minocycline during which he had no recurrence of brain abscess. Thus, brain nocardiosis could be successfully treated with appropriate antibiotics. The lesson from the present case is that identification of the type of nocardia by PCR analysis of 16S ribosomal DNA could help accomplish tailor-made antibiotic therapy. (author abst.)
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