Posttraumatic exogenous Nocardia endophthalmitis.

PURPOSE: To report a case of posttraumatic exogenous Nocardia endophthalmitis.

DESIGN

Interventional case report.

METHOD: A 46-year-old man presented with counting fingers vision, severe eye pain, hypopyon, and an iris mass consistent with endophthalmitis following a penetrating injury to the left eye.

RESULTS

Despite oral fluconazole and repeated intravitreal injections of vancomycin, gentamicin, and amphotericin B, the eye remained painful with a persistent hypopyon and recurrent iris masses. Cultures of the vitreous and iris masses remained negative for organisms. Despite vitrectomy and sector iridectomy of the iris mass with repeat injections of intravitreal antibiotics, the patient continued to have severe pain, poor vision, and developed new iris masses. Enucleation cultures confirmed Nocardia asteroides.

CONCLUSIONS

Posttraumatic exogenous Nocardia endophthalmitis is extremely rare, and its clinical signs can mimic a fungal infection.