Rare Case of Disseminated Nocardia transvalensis in an Immunocompetent Host

We report the case of an immunocompetent patient presenting with lumbar pain diagnosed and treated for disseminated Nocardia transvalensis infection, a rare species of Nocardia typically known to infect immunocompromised hosts. Our patient underwent an MRI demonstrating possible abscess and subtle osteomyelitis of the L3-L4 facet joint and transverse process; a subsequent biopsy resulted in Nocardia transvalensis. Further imaging with a CT head revealed a 9 mm enhancing supratentorial lesion. This case highlights the clinical pathogenesis of Nocardia transvalensis in an unusual host, the diagnostic approach to confirming active Nocardia infection, and the susceptibility patterns in a relatively unstudied organism.