诺卡氏菌,机会主义者,革兰氏阳性,过氧化氢酶阳性,在土壤和水中发现的杆状细菌,已知会导致人类感染,主要在免疫受损的个体中,通过吸入或直接接种。本报告详细介绍了一例罕见的由巴西诺卡氏菌引起的败血症关节,随后导致皮肤受累,患有多种潜在健康问题的患者。由于患者的广泛病史,该病例的处理变得复杂,包括糖尿病,慢性尿路感染,以及最近的外科手术,这就需要一种微妙的抗生素治疗方法。为了应对其他器官的并发感染和多药耐药生物的出现,治疗方案进行了几次调整。尽管诺卡氏菌感染的治疗方案越来越多,由于潜在的不良后果,治疗此类感染仍然具有挑战性,特别是在容易感染复发的免疫功能低下的患者中。该病例强调了诊断和管理诺卡氏菌感染的复杂性,并强调了定制抗生素治疗在实现有利结果同时将复发风险降至最低的重要性。
Nocardia, an opportunistic, gram-positive, catalase-positive, rod-shaped bacterium found in soil and water, is known to cause infections in humans, predominantly among immunocompromised individuals, through inhalation or direct inoculation. This report details a rare case of a septic joint caused by Nocardia brasiliensis, which subsequently led to cutaneous involvement, in a patient with multiple underlying health issues. The management of this case was complicated by the patient\'s extensive medical history, including diabetes, chronic urinary tract infections, and recent surgical procedures, which necessitated a nuanced approach to antibiotic therapy. The treatment regimen underwent several adjustments in response to concurrent infections in other organs and the emergence of multidrug-resistant organisms. Despite an expanded arsenal of therapeutic options for Nocardia infections, treating such infections remains challenging due to potential adverse outcomes, particularly in immunocompromised patients prone to infection relapse. This case underscores the complexities involved in diagnosing and managing Nocardia infections and highlights the importance of tailored antibiotic therapy in achieving favorable outcomes while minimizing the risk of relapse.