Abstract Osteomyelitis is an inflammation process of bone caused by a pathogenic microorganism and associated by edema, thrombosis of small vessels and eventually bone necrosis. Infection of bone occurs as a consequence of hematogenous dissemination of bacteria, invasion from a contiguous focuw of infection and skin breakdown. We report a case of lower limbs osteomyelitis due to Nocardia spp in a 68 years old man with Granulomatosis with Polyangiitis (GPA) during his treatment of underlying vasculitis. This case indicates considering rare pathogens in immunosuppressed patients.