Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 39 2 2001 06 15 118 121 Saberi H Fakhr Tabatabai SA Hussain Khan Z 2015 09 28 Central nervous system ranks among the favorite sites to get involved by Nocardia astroides. This opportunistic organism complicates many disorders characterized by cellular or humoral immunity disturbances.A 36-year-old woman is being presented, known to have systemic lupus erythematosus (SLE) and having received a two year course of corticosteroid treatment. Cerebellar abscess was found on diagnostic imagings performed because of heddaches and dysequilibrium of two weeks duration.Craniectomy was performed and the abscess excised. Nocardia astroides grew in the pus culture. On switching the empirical therapy to a combination of trimethoprimsulfamethoxazole and vancomycin, the patient exhibited dramatic improvement in symptoms later on and postoperative imaging showed an absence of the lesion. We recommend a high index of clinical suspicion for nocardia abscess in patients suffering from SLE and presenting with neurological treatment presents the only plausible option https://acta.tums.ac.ir/index.php/acta/article/view/2418 https://acta.tums.ac.ir/index.php/acta/article/download/2418/2407