Nocardia septic arthritis of the hip with associated avascular necrosis. A case report.

Nocardiosis is a rare infection seen most commonly in immunocompromised patients. Most have pulmonary involvement, but some develop disseminated infection. There are few case reports of septic arthritis attributable to hematogenous nocardiosis. In this case, a heart transplant patient was ultimately proven to have a Nocardia septic hip but represented a diagnostic challenge because of preexisting avascular necrosis. With the increasing number of allograft recipients and concomitant immunosuppression, the possibility of an increase in Nocardia opportunistic infections exists. Avascular necrosis, attributable to corticosteroid use, may predispose patients to hip joint infection.