Endogenous Nocardia Endophthalmitis Presenting as a Mass Lesion in a Patient With Metatstatic Nonsmall Cell Carcinoma of the Lung

Purpose Endogenous endophthalmitis is uncommon but potentially dangerous. We present a fatal presentation of endogenous Nocardial endophthalmitis in the context of steroid use for treatment of giant cell arteritis. Case Presentation An 84-year-old Caucasian female presented to the local emergency room with severe headaches, myalgia and shoulder and calf muscle pain. She was treated for a presumed diagnosis of giant-cell arteritis with corticosteroids and subsequently developed an intense retro-orbital pain in the right eye. Fundus examination revealed a white, vascularized chorioretinal mass at the equator of the eye in the inferotemporal quadrant. Antibiotics were given and a vitrectomy was performed. The culture of the vitreous showed Nocardia nova and a diagnosis of disseminated Nocardiosis was made. Conclusion and Significance Although uncommon, it is important that ophthalmologists are aware of Nocardial infections as a differential diagnosis of retinal mass, particularly in immunocompromised patients.

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A Case Report of Endogenous Endophthalmitis in the Setting of Nocardia kroppenstedtii Infection

Venkat¹,

Baynes²,

Lowder³

et al. 2019

Ophthalmic Surg Lasers Imaging Retina

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A woman with a past medical history of radiation and chemotherapy for multiple malignancies presented with bilateral, multifocal, elevated chorioretinal lesions associated with vitritis. The differential diagnosis included endogenous endophthalmitis and metastatic disease. Her extensive medical history and ill appearance at presentation in concert with vitritis and subretinal lesions was concerning for endogenous endophthalmitis. Although her vitreous sample was negative, her blood cultures were positive for Nocardia kropenstedtii and Nocardia farcinica . She was started on broad-spectrum antibiotic coverage but had brain lesions on presentation and ultimately passed away. This is the first reported case of Nocardia endophthalmitis in the setting of systemic N. kroppenstedtii infection. [ Ophthalmic Surg Lasers Imaging Retina. 2019;50:53–55.]

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Endogenous Nocardia Endophthalmitis Presenting as a Mass Lesion in a Patient With Metatstatic Nonsmall Cell Carcinoma of the Lung

Cited by 3 publications

References 14 publications

Clinicopathological, Microbiological and Polymerase Chain Reaction Study in a Case of Nocardia Scleritis

Clinicopathological, Microbiological and Polymerase Chain Reaction Study in a Case of Nocardia Scleritis

<p>Endogenous <em>Nocardial</em> Endophthalmitis Misdiagnosed as Giant Cell Arteritis</p>

A Case Report of Endogenous Endophthalmitis in the Setting of Nocardia kroppenstedtii Infection

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