Endogenous Ocular Nocardiosis—An Interventional Case Report With a Review of the Literature

Eschle-Meniconi, Margherita E.; Guex-Crosier, Yan; Wolfensberger, Thomas J.

doi:10.1016/j.survophthal.2011.03.003

Cited by 37 publications

(36 citation statements)

References 122 publications

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“…[2] Nocardial infections in the eye manifests as keratitis, scleritis, and endophthalmitis. Keratitis and scleritis are mostly associated with exposure to soil and plant matter.…”

Section: Discussionmentioning

confidence: 99%

Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder

Trehan¹,

Kaushik²,

Jain³

et al. 2017

J Ophthalmic Vis Res

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Purpose:To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome.Case Report:A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes.Conclusion:Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.

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“…[2] Nocardial infections in the eye manifests as keratitis, scleritis, and endophthalmitis. Keratitis and scleritis are mostly associated with exposure to soil and plant matter.…”

Section: Discussionmentioning

confidence: 99%

Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder

Trehan¹,

Kaushik²,

Jain³

et al. 2017

J Ophthalmic Vis Res

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“…Sulfamethoxazole (SMX) entered the eye slowly and had lower levels in aqueous (20-26% that of plasma levels) but remained there for a much longer time. [5] Aqueous levels of usual doses of TM/SMX after 7 days of systemic treatment have been shown to be 1.37 / 15.5 μg/ml while the MIC90 determined at 1/19 μg/ml. [5] Intra-ocular levels of double strength dosages have not been studied.…”

Section: Case Reportmentioning

confidence: 97%

“…[5] Aqueous levels of usual doses of TM/SMX after 7 days of systemic treatment have been shown to be 1.37 / 15.5 μg/ml while the MIC90 determined at 1/19 μg/ml. [5] Intra-ocular levels of double strength dosages have not been studied. Non-response may require the use of amikacin, ciprofl oxacin or newer antibiotics such as imipenem and linezolid.…”

Section: Case Reportmentioning

confidence: 97%

“…In half of these, the ocular nocardiosis clearly preceded systemic disease which may warrant systemic evaluation for the primary site of infection and the cause for immunosuppression if not already known. [5] Endogenous endophthalmitis usually presents as choroidal lesions and thickened overlying retina with little or no vitreous infl ammation. [4] In contrast, exogenous endophthalmitis occurring after intra-ocular surgery or penetrating trauma is commonly confi ned to the anterior segment with characteristic yellowish-white iris nodules, corneal endothelial deposits and a hypopyon.…”

Section: Case Reportmentioning

confidence: 99%

“…Non-response may require the use of amikacin, ciprofl oxacin or newer antibiotics such as imipenem and linezolid. [5] In addition to antibiotic treatment, some authors recommend early surgical intervention as they believe that inadequate response to medical therapy is due to poor antibiotic penetration. [2] However, since the poor prognosis has been attributed to severe anterior chamber infl ammation with ciliary body membranes and phthisis, [1] control of infl ammation seems a logical part of treatment.…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Management of post-operative Nocardia endophthalmitis

Pradhan

Jacob

Korah

2012

Indian Journal of Medical Microbiology

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Post-operative Nocardia endophthalmitis has an aggressive course and poor visual prognosis. It often masquerades as severe post-operative uveitis or toxic anterior segment syndrome due to the absence of vitreous involvement resulting in a delay in diagnosis. The poor prognosis in Nocardia endophthalmitis is due to severe intra-ocular inflammation which may lead to phthisis. Therefore, treatment with corticosteroids after appropriate antibiotics have been initiated may improve the outcome. This is an interventional case report highlighting the typical features of Nocardia endophthalmitis, which when diagnosed early and managed medically with antibiotics and steroids, resulted in an excellent visual outcome in our patient.

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Bilaterale 4MRGN-Pseudomonas-aeruginosa-assoziierte choroidale Abszesse bei Mukoviszidose

et al. 2018

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We present a case of bilateral choroidal abscesses due to a multidrug-resistant gram negative (4MRGN) Pseudomonas aeruginosa lung colonization in a patient with cystic fibrosis under immunosuppression after lung transplantation. Bilateral choroidal and subretinal abscesses were detected by funduscopy, ultrasound, magnetic resonance imaging (MRI) and phacovitrectomy and were accompanied by bilateral acute vision loss. The diagnosis was confirmed by intraoperative subretinal biopsy. Due to therapy resistance a bilateral enucleation for life-saving purposes was performed.

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Endogenous Ocular Nocardiosis—An Interventional Case Report With a Review of the Literature

Cited by 37 publications

References 122 publications

Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder

Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder

Management of post-operative Nocardia endophthalmitis

Bilaterale 4MRGN-Pseudomonas-aeruginosa-assoziierte choroidale Abszesse bei Mukoviszidose

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