Septic arthritis caused by Nocardia asteroides in a renal transplant recipient

Transplant Proc. 2004 Jun;36(5):1415-8. doi: 10.1016/j.transproceed.2004.05.048.


Although articular complications are common following renal transplantation, septic arthritis is not frequent. Previous bacterial infection in an another site is a consistent finding and the knee is the most often affected joint. We present a 30-year-old female renal transplant recipient with recurrent pulmonary infiltrates preceding septic arthritis of her left knee. Cultures of the aspirated synovial fluid yielded a gram-positive, rod-shaped bacterium later identified as Nocardia asteroides. The patient was treated with oral trimethoprim-sulfamethoxazole without any side effect. Nocardia is a rare but serious cause of infection in renal transplant recipients but there is no well-known predisposing factor. Recently mycophenolate mofetil has been implicated as a factor associated with Nocardia infections. Prolonged courses of treatment with sulphonamides are recommended.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Arthritis, Infectious / diagnostic imaging
  • Arthritis, Infectious / drug therapy
  • Arthritis, Infectious / microbiology*
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Humans
  • Kidney Transplantation*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / microbiology
  • Middle Aged
  • Nocardia Infections / complications*
  • Nocardia Infections / diagnostic imaging
  • Nocardia Infections / drug therapy*
  • Nocardia asteroides*
  • Postoperative Complications / microbiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Anti-Bacterial Agents