Septic arthritis due to Nocardia brasiliensis and a review of nocardiosis as a cause of arthritis

Divya Chandramohan, Heta Javeri, Gregory M. Anstead

Research output: Contribution to journalArticlepeer-review

Abstract

Bacteria of the genus Nocardia are implicated in several disease processes but are a rare cause of septic arthritis. Typically, the cause of Nocardia septic arthritis is dissemination from a pulmonary infection in an immunocompromised host. Herein we present a case of a 64-year-old male who had received a long course of prednisone for membranous nephropathy and developed a septic arthritis due to Nocardia brasiliensis. He was treated sequentially with trimethoprim-sulfamethoxazole and amoxicillin-clavulanate, linezolid and amoxicillin-clavulanate, tigecycline and amoxicillin-clavulanate, and omadacycline and amoxicillin-clavulanate. To our knowledge, only two prior cases of Nocardia brasiliensis septic arthritis without antecedent trauma to the joint or local skin breakdown have been reported. A review of the literature identified 19 other cases of Nocardia septic arthritis. This case reinforces the need to consider Nocardia infection in the differential diagnosis in the immunocompromised patient with concurrent pulmonary infection and septic arthritis.

Original languageEnglish (US)
Article numbere01590
JournalIDCases
Volume29
DOIs
StatePublished - Jan 2022

Keywords

  • Disseminated nocardiosis
  • Immunocompromised
  • Nocardia brasiliensis
  • Septic arthritis

ASJC Scopus subject areas

  • Infectious Diseases

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