Disseminated Nocardiosis with retinal abscess in a patient treated for bullous pemphigoid

Abstract

PurposeTo report a case of disseminated Nocardiosis with retinal and intracranial lesions.ObservationsA 49-year-old woman immunosuppressed because of treatment given for bullous pemphigoid presented with altered mental status and multiple intracranial lesions on imaging. The patient was found to have multiple retinal lesions in both eyes, including a subretinal abscess in the right eye. The patient underwent brain biopsy, confirming Nocardia farcinica histopathologically and in culture.Conclusions and ImportanceOcular Nocardiosis is a rare disease with varying prognosis that requires prompt diagnosis to ensure appropriate medical therapy.

Nocardia Subretinal Abscess: A Rare and Challenging Case Report

“…Severity of the ocular manifestations can be highly variable, which makes diagnosis difficult. Ocular Nocardia presentation can range from minimal inflammation to significant vitritis [ 16 ]. The fundoscopic findings are usually subretinal abscess, chorioretinal exudate, or inflammatory mass with associated superficial or intraretinal hemorrhages.…”

Endogenous ocular nocardiosis

“…Nocardia endophthalmitis can occur in the immunocompetent but is less common [ 7 ]. Diagnosis can be very difficult due to the variation in symptoms and severity at presentation [ 8 ].…”

Brain Abscess Due To Asian Nocardia in a 63 Years-Old Patient with Adult Still´S Disease: A Rare Case Report and Literature Review

“…Nocardiosis is an infectious disease caused by a gram-positive, aerobic bacterium of the order of Actinomycetes, [1,2] such as Nocardia asteroides and Nocardia caviae that act as opportunists and is found in soil, water and organic matter. In addition, it is acquired through inhalation therefore produces pneumonia (75% of cases) and can involve central nervous system (25% of cases), skin and other organs by hematogenous spread [7].…”