Nodular non-necrotising anterior scleritis due to Nocardia nova infection

Das, Sujata; Saunders, M.; Cheng, Allen; Whiting, Mark

doi:10.1038/sj.eye.6702524

Cited by 10 publications

(16 citation statements)

References 9 publications

(5 reference statements)

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“…The predisposing factors include steroid use, diabetes mellitus, combined penetrating keratoplasty and PEA with IOL implantation, sclera buckle surgery, trauma, and cataract surgery ( Table 2). [6][7][8][9][10][11][12][13] In our patient, prior cataract surgery and farm work were probably the cause of the infectious scleritis, but the exact cause was not determined.…”

Section: Discussionmentioning

confidence: 66%

Necrotizing Nocardial Scleritis Successfully Treated with Surgical Debridement and Topical Polyvinyl Alcohol Iodine and Antibiotics

Maruo¹,

Shiraishi

Hara

et al. 2011

Journal of Ocular Pharmacology and Therapeutics

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Section: Discussionmentioning

confidence: 66%

Necrotizing Nocardial Scleritis Successfully Treated with Surgical Debridement and Topical Polyvinyl Alcohol Iodine and Antibiotics

Maruo¹,

Shiraishi

Hara

et al. 2011

Journal of Ocular Pharmacology and Therapeutics

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“…4a, b). Although rare, Nocardia scleritis has been reported frequently in literature as isolated case reports [27][28][29][30][31][32][33][34][35][36][37][38][39]. Sahu et al [27] reported a series of three patients and reviewed the literature for this entity.…”

Section: Presentation Specific To Etiological Agentsmentioning

confidence: 97%

“…In the recent years, there has been an increase in the number of cases of ocular infection due to scleritis are mainly cataract surgery [1 • , 29], scleral buckling surgery [1 • , 31, 32], penetrating keratoplasty [33], subtenon triamcinolone acetonide injection for cystoid macular edema [34], trauma [35], and contact lens wear [36,37]. Nocardia asteroides was the most predominant organism followed by Nocardia nova [38].…”

Section: Microbiological Profilementioning

confidence: 99%

Infectious Scleritis

Murthy

Reddy

Sharma

et al. 2015

Curr Ophthalmol Rep

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Scleritis is a rare but painful, indolent, locally destructive, and devastating disease of the sclera. While immune-mediated scleritis with or without systemic association forms a vast majority of the cases seen in the clinics, approximately 5-18 % of all cases of scleritis can be due to infectious process. The challenges in the diagnosis and management of infectious scleritis are multiple. The diagnosis is often delayed due to the close similarity of clinical presentation between non-infectious and infectious etiology, and also because the clinical signs of infection may be obvious only in the late stages. In addition, the use of corticosteroids in presumed non-infectious scleritis further complicates the management. Microbiological diagnosis is often elusive as the organisms lie deep within the scleral layers and repeated biopsy is sometimes required for its identification. These microbes can be indolent in nature and traditional testing to detect them may not suffice. The management of infectious scleritis is fraught with multiple hurdles. In the case of medical management, the avascular scleral tissue has poor penetration of topically applied medications-especially antifungal agents, necessitating additional parenteral therapy for prolonged periods. Surgical modalities such as debridement of infected and necrotic tissue are mandatory. In this review, we describe the clinical features, differential diagnosis, and microbiological spectrum of infectious scleritis. This review also highlights the medical and surgical management of this difficult entity and will provide a comprehensive literature review of this disease.

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“…Final visual acuity in previous reports ranges from 20/20 to 20/400. 19,20 In cases of infectious scleritis, poorer outcomes are associated with presenting visual acuity worse than 20/200 and concomitant keratitis or endophalmitis.…”

Section: Discussionmentioning

confidence: 99%

“…Das et al reported a case of Nocardia scleritis in a patient presenting with pain and injection of the left eye with a history of a mud splash to the face 1 week prior to symptom onset. 19 This patient was treated at the time of presentation with high-dose systemic corticosteroids, which resulted in worsening of the underlying infection. Corticosteroids are known to worsen Nocardia infection mainly by inhibiting the release of host lysosomal enzymes essential to destruction of the phagocytosed intracellular Nocardia organisms.…”

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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Nodular non-necrotising anterior scleritis due to Nocardia nova infection

Cited by 10 publications

References 9 publications

Necrotizing Nocardial Scleritis Successfully Treated with Surgical Debridement and Topical Polyvinyl Alcohol Iodine and Antibiotics

Necrotizing Nocardial Scleritis Successfully Treated with Surgical Debridement and Topical Polyvinyl Alcohol Iodine and Antibiotics

Infectious Scleritis

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

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