Disseminated Nocardia farcinica infection associated with bacteraemia and osteomyelitis pubis in an elderly patient

Abstract

Objective

We describe a rare case of a disseminated Nocardia farcinica infection associated with hip osteomyelitis.

Methods

A 91-year-old female patient was admitted with oedema of her right leg, fever of 38 °C and data consistent with ruptured Baker’s cyst. A disseminated Nocardia farcinica infection including bloodstream infection, pneumonia and multiple abscesses along both lower limbs was observed.

Results

After a four-week course of 320 mg/1600 mg/12 h of intravenous trimethoprim/sulfamethoxazole and multiple chirurgic drainages the patient was discharged with oral trimethoprim/sulfamethoxazole. Nevertheless, the patient expired done month after being discharged from the hospital.

Conclusions

The implementation of a combination of intravenous antibiotics and drainages resulted in an initial improvement in the patient’s condition. However, despite these interventions, the patient ultimately passed away probably due to natural causes.

Keywords:

• Norcardia farcinica
• abscesses
• disseminated infection
• bacteraemia
• osteomyelititis