Nocardia prosthetic knee infection successfully treated by one-stage exchange: case report and review

Acta Clin Belg. 2015 Aug;70(4):287-90. doi: 10.1179/2295333714Y.0000000109. Epub 2015 Jan 6.

Abstract

A 64-year-old man with a history of sarcoidosis on corticosteroids and azathioprine was admitted to our hospital with complaints of worsening left knee pain and swelling for the past 3 weeks. His past medical history is also significant for severe osteoarthritis requiring a cemented total left knee arthroplasty 1 year ago. Diagnostic investigation during his hospital admission eventually led to the diagnosis of Nocardia nova knee prosthetic joint infection in the setting of a disseminated nocardiosis. He was successful treated by one-stage complete hardware exchange in conjunction with an adapted antibiotic therapy regimen (meropenem and doxycycline followed by ceftriaxone and doxycycline). Two years later, his recovery was deemed excellent.

Keywords: Immunodepression,; Knee,; Nocardia nova,; One-stage exchange; Prosthetic joint infection,; Sarcoidosis,.

Publication types

  • Case Reports

MeSH terms

  • Comorbidity
  • Device Removal
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunocompromised Host
  • Knee Prosthesis / adverse effects*
  • Middle Aged
  • Nocardia Infections / drug therapy
  • Nocardia Infections / epidemiology
  • Nocardia Infections / surgery*
  • Osteoarthritis, Knee / surgery
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / surgery*
  • Sarcoidosis / epidemiology