<p><b>Background</b><span>: </span>Nocardia<span> are a group of bacteria known to cause pulmonary, cutaneous, neurologic, or disseminated diseases, usually in immunocompromised hosts. Within the </span>Nocardia<span> family is </span>Nocardia transvalensis<span>, a rarely encountered and underreported organism in the clinical literature. </span></p>
<p><b>Case</b><span>: Here, we report the case of an immunocompetent patient presenting with lumbar pain diagnosed and treated for disseminated </span>Nocardia transvalensis<span> infection. Our patient underwent magnetic resonance imaging (MRI), demonstrating possible abscess and subtle osteomyelitis of the L3-L4 facet joint and transverse process; a subsequent biopsy and culture resulted in </span>Nocardia transvalensis<span>. Further imaging with a computed tomography (CT) scan of the head revealed a 9 mm enhancing supratentorial lesion. The patient was treated with empiric antibiotics, but this was narrowed to levofloxacin, linezolid, and trimethoprim-sulfamethoxazole after antibiotic sensitivities cropped up. </span></p>
<p><b>Conclusions</b><span>: Within this case, we extensively discuss the clinical pathogenesis of </span>Nocardia transvalensis<span> in an unusual host, the diagnostic approach to confirming active </span>Nocardia <span>infection, and the susceptibility patterns in a relatively unstudied organism.</span></p>
