Nocardia farcinica is a rare pathogen that occurs mainly in immunocompromised people.[1] The case describes an elderly patient with infectious arthritis and myositis in the right shoulder, who had diabetes, low immunity and received corticosteroid injections.[1] The bacterium was identified using modern genetic testing (mNGS) and culturing a sample of joint fluid.[1] Treatment was challenging because the bacterium was resistant to the first antibiotic (TMP-SMX) and the patient had poor drug tolerance, necessitating a change to linezolid and later to minocycline.[1] Due to the poor response to antibiotic treatment, several surgical procedures were required to remove the infected tissue.[1] The case highlights the importance of considering this rare bacterium in immunocompromised patients with atypical infections unresponsive to standard therapy.[1] Rapid identification of the pathogen and surgical intervention are critical for successful treatment of such infections.[1]