Postoperative<i>Nocardia</i>Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin

Lodhi, Sikander A. K.; Reddy, G. Ashok Kumar; Sunder, C. Aruna

doi:10.1155/2016/2365945

Cited by 6 publications

(4 citation statements)

References 11 publications

(11 reference statements)

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“…Only after a later microbiological sample yielded a negative result; was the oral sulfamethoxazole/trimethoprim combination discontinued 12. While some cases required more than 3 months of systemic medication,13 other authors have reported favourable outcomes for N. endophthalmitis after 6–10 weeks of oral therapy 14 30. According to Sharma and O’Hagan,31 the infection resurfaced following the application of topical steroids, requiring reintroduction of oral sulfamethoxazole/trimethoprim.…”

Section: Discussionmentioning

confidence: 99%

Nocardia keratitis presenting as an anterior chamber ball of exudates and its management

et al. 2023

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A man in late 40s presented with corneal ulcer of the right eye of 1 month duration. He had a central corneal epithelial defect measuring 4.6×4.2 mm with an underlying 3.6×3.5 mm anterior to mid stromal patchy infiltrate and 1.4 mm hypopyon. Gram stain of the colonies on chocolate agar showed presence of confluent thin branching, gram-positive beaded filaments, which were positive after 1% acid fast stain. This confirmed our organism to be Nocardia sp. Topical amikacin was started but continued worsening of the infiltrate and presence of a ball of exudates in the anterior chamber, prompted the use of systemic trimethoprim-sulfamethoxazole. There was a dramatic improvement in the signs and symptoms, with complete resolution of infection over a period of 1 month.

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Section: Discussionmentioning

confidence: 99%

Nocardia keratitis presenting as an anterior chamber ball of exudates and its management

et al. 2023

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“…[ 5 , 18 , 19 ] It has been reported that vitreous body injection of amikacin may lead to macular necrosis. [ 20 , 21 ] However, there are no effective antibiotics that can control infection through anterior chamber injection. In addition, the iris has significant inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Successful control of scleritis caused by Nocardia farcinica: A case report

et al. 2022

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Rationale: Nocardia farcinica is an opportunistic pathogen that rarely causes ocular infections. This study reviewed a case of N. farcinica-mediated scleritis involving the corneal limbus. Patient concerns: A 56-year-old man was admitted to the Department of Keratology of Jinan Second People’s Hospital due to “a red and swollen right eye accompanied with severe pain for >1 month.” He denied any history of hypertension, diabetes, systemic immune diseases and eye surgery. Diagnoses: Corneal defect and scleral necrosis were observed by slit lamp. Combination of anterior segment optical coherence tomography and ophthalmic ultrasound biomicroscopy was used for diagnosis and evaluation of corneal and scleral conditions. Culture and metagenomic sequencing verified that the pathogen of scleritis was N. farcinica. Interventions: The patient was treated by sulfacetamide sodium eye drops, oral administration of sulfamethoxazole tablets, amikacin anterior chamber flushing, scleral debridement, and allogeneic scleral transplantation. Outcomes: The disease was successfully controlled. Lessons: Infectious scleritis caused by N. farcinica is extremely rare. Culture of pathogenic microorganisms remains to be the gold standard for the diagnosis of infectious eye diseases. Metagenomic sequencing shows potential promise in the diagnosis of infectious eye diseases. N. farcinica is sensitive to sulfonamides and amikacin.

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“…An incorrect diagnosis is often assumed, and a more common pathogen of mycotic origin is then considered. Because of the delayed causal treatment in these types of cases, significant ocular morbidity, including enucleation of the eye, cannot be prevented in most cases [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic exogenous endophthalmitis caused by Nocardia farcinica

Burdová

Donátová

Mahelková

et al. 2021

J Ophthal Inflamm Infect

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A case report of post-traumatic exogenous endophthalmitis caused by Nocardia farcinica, including treatment procedures, microbiology examination, and systemic medications. A 23-year-old male suffered a penetrating corneal injury that was treated with sutures. On the thirteenth day after the final suture was removed, an anterior uveitis developed and progressed to whitish, plump, nodular, and tufted exudates within the anterior chamber over the next 10 days; this led to an indication for intraocular surgery. Anterior chamber lavage and resection of solid fibrinous exudates (using a vitrectomy knife) for a complete microbiological examination were performed. Nocardia farcinica was identified. Systemic medications were chosen according to sensitivity, and a fixed combination of sulfamethoxazole 400 mg/trimethoprim 80 mg was administered long-term (months). In this case, accurate, early detection of an atypical infectious agent and determination of its sensitivity to antibiotic treatment enabled effective treatment that achieved the best functional and anatomical results under the circumstances.

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PostoperativeNocardiaEndophthalmitis and the Challenge of Managing with Intravitreal Amikacin

Cited by 6 publications

References 11 publications

Nocardia keratitis presenting as an anterior chamber ball of exudates and its management

Nocardia keratitis presenting as an anterior chamber ball of exudates and its management

Successful control of scleritis caused by Nocardia farcinica: A case report

Post-traumatic exogenous endophthalmitis caused by Nocardia farcinica

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