Optimizing Diagnosis and Management of Nocardia Keratitis, Scleritis, and Endophthalmitis: 11-Year Microbial and Clinical Overview

DeCroos, Francis Char; Garg, Prashant; Reddy, Ashok Kumar; Sharma, Ashish; Krishnaiah, Sannapaneni; Mungale, Meeta; Mruthyunjaya, Prithvi

doi:10.1016/j.ophtha.2010.10.037

Cited by 71 publications

(106 citation statements)

References 44 publications

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“…Further, non-fungal microorganisms such as acanthamoeba, nocardia and Grampositive bacteria can present with clinical features resembling fungal infection. 8,9 Therefore, no clinical feature can be considered absolutely pathognomonic of fungal aetiology. 10 Challenges with laboratory diagnosis Although microscopic examination of smear using various stain and inoculation on culture media helps in identification of fungal infections, laboratory diagnosis can be challenging, especially in patients with deepseated keratitis.…”

Section: Keratitismentioning

confidence: 99%

Fungal, Mycobacterial, and Nocardia infections and the eye: an update

Garg

2011

Eye

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Although relatively uncommon, fungi, atypical Mycobacteria, and Nocardia have been isolated from a variety of infections of eye including keratitis, scleritis, canaliculitis, dacryocystitis, endophthalmitis and orbital cellulites. The organisms typically cause a slowly progressive disease. The diseases caused by the organisms can pose both diagnostic and therapeutic challenges. In this manuscript we will describe updates on important aspects of the ocular infections caused by these organisms.

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Section: Keratitismentioning

confidence: 99%

Fungal, Mycobacterial, and Nocardia infections and the eye: an update

Garg

2011

Eye

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“…Nocardia species cause a wide spectrum of diseases including pulmonary nocardiosis; cutaneous and subcutaneous nocardiosis [1,17,18]. In a study by DeCroos et al ocular exposure to soil or plant matter was a common historical point in cases of Nocardia keratitis (48%) and scleritis (45%), respectively [5]. Nocardia produce the secondary metabolism such as antibiotics like tubelactomicin A.…”

Section: Discussionmentioning

confidence: 99%

“…Nocardia infections can cause pulmonary disease in both immune-compromised and healthy individuals [4]. Nocardia infections are initiated by inhalation of the organisms or through traumatic(such as primary cutaneous Nocardial infection) [5,6]. Nocardia species are found as saprophytic components in natural habitats such as soil, dust, fresh and saltwater or the surfaces of plants, so the presence of these agents in laboratory or respiratory samples may represents contamination or acquisition of infection from their natural environment that diagnosed with clinical signs, radiological finding and especially culture of Nocardia [1].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Various Methods for Isolation of Nocardia from Soil

Rasoulinasab

Fatahi-Bafghi

Habibnia

et al. 2017

Zahedan J Res Med Sci

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Background: The genus Nocardia is Gram-positive, aerobic filamentous bacilli and saprophytic micro-organisms that can be isolated from freshwater, salt water, dust and decaying vegetation especially the soil. This study aimed to investigate the several media for to determine a suitable culture media with the ability to better for the isolation of Nocardia from soil. Methods:In this study, 400 soil samples were collected from different areas from Iran. The soil samples were then cultured on the four culture media such as Humic acid vitamin B agar, Paraffin agar, Sabouraud dextrose agar supplemented whit cycloheximide and carbon-free broth containing paraffin rods and incubated at 35°C. All of culture media investigated every 3 days for a month. Colonies suspicious to Nocardia were stained with Gram-stain, acid-fast and partially acid-fast and evaluated for resistance to lysozyme.Results: From 400 soil samples, the number of 62, 10, 28 and 19 strains of Nocardia were isolated by paraffin rods, Humic Acid Vitamin B agar, Paraffin agar and Sabouraud dextrose agar whit cycloheximide, respectively. Most Nocardia strains were isolated using paraffin bait technique. Conclusions:Isolation of Nocardia spp. is enhanced by using the paraffin baiting technique that relies on the selective ability of this micro-organism to metabolize paraffin.

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“…11 A majority of patients with Nocardia scleritis present with nonspecific signs, such as pain, conjunctival injection, scleral abscess, or scleral nodule. 12,14,17,18 A high index of suspicion for Nocardia infection should be maintained when a patient presents with a history of ocular trauma, associated history of farm work, or a unilateral lesion. 16 In our case, the patient's primary risk factor included contact-lens wear.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical intervention is employed in the majority of cases that result in complete cure. 14,15,17,18,20,21 Jain et al maintains that surgical debridement is important in facilitating the penetration of antibiotics and in debulking infected tissue. 20 Despite limited data, we believe that there could be a role for subconjunctival and sub-Tenon's antibiotics, even though we did not use them.…”

Section: Discussionmentioning

confidence: 99%

Second report of a Nocardia beijingensis infection in the United States: nodular scleritis with in vitro imipenem resistance

et al. 2016

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SummaryWe describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain of Nocardia beijingensis. The patient presented with pain, redness, and nodules on the sclera of 8 weeks' duration. A Gram stain from a nodule on the superonasal aspect of the globe was initially negative. After empiric treatment for an autoimmune etiology, cytopathology confirmed filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made, and medical management was based on a literature review on treatments for Nocardia infections. Cultures returned confirming Nocardia beijingensis. Antibiotic sensitivity testing confirmed the correct initial management. The patient's scleritis resolved with a good visual outcome.

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Optimizing Diagnosis and Management of Nocardia Keratitis, Scleritis, and Endophthalmitis: 11-Year Microbial and Clinical Overview

Cited by 71 publications

References 44 publications

Fungal, Mycobacterial, and Nocardia infections and the eye: an update

Fungal, Mycobacterial, and Nocardia infections and the eye: an update

Comparison of Various Methods for Isolation of Nocardia from Soil

Second report of a Nocardia beijingensis infection in the United States: nodular scleritis with in vitro imipenem resistance

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