Nocardia brasiliensis endophthalmitis in a patient with an exposed Ahmed glaucoma drainage implant.

PURPOSE: To report a case of endophthalmitis due to Nocardia brasiliensis in an eye with an exposed, infected Ahmed glaucoma drainage implant (GDI).

DESIGN

Retrospective case report.

METHODS

A patient with an exposed GDI experienced recurrent episodes of endophthalmitis despite repeated intravitreal injections of antibiotics and steroids. The tube was initially repositioned and finally removed.

RESULTS

Whereas repeated cultures from the anterior chamber and vitreous were negative, cultures from the removed tube grew Nocardia brasiliensis. Despite oral trimethoprim-sulfamethoxazole and intravitreal amikacin the eye became phthisical and lost light perception.

CONCLUSIONS

An exposed GDI may lead to endophthalmitis due to Nocardia brasiliensis and may require explantation to establish a diagnosis.