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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.
摘要：
诺卡氏菌属细菌与多种疾病过程有关，但却是化脓性关节炎的罕见原因。通常,诺卡氏菌化脓性关节炎的原因是肺部感染在免疫功能低下的宿主中传播。在此，我们介绍了一例64岁的男性，该男性接受了长时间的泼尼松治疗膜性肾病，并因巴西诺卡氏菌而患上了化脓性关节炎。他依次接受甲氧苄啶-磺胺甲恶唑和阿莫西林-克拉维酸治疗，利奈唑胺和阿莫西林克拉维酸，替加环素和阿莫西林克拉维酸，以及奥马环素和阿莫西林-克拉维酸。据我们所知,据报道，只有两例先前的巴西诺卡氏菌化脓性关节炎病例，没有对关节或局部皮肤的先前创伤。对文献的回顾确定了其他19例诺卡氏菌化脓性关节炎。这种情况加强了在合并肺部感染和脓毒性关节炎的免疫功能低下患者的鉴别诊断中考虑诺卡氏菌感染的必要性。
